{"paper_id":"1174ddc7-cdcc-4885-9c1e-a621e6d01888","body_text":"Seven-Year Comparative Outcomes of One Anastomosis Gastric Bypass and Roux-en-Y Gastric Bypass for Weight Recurrence Regain Post Sleeve Gastrectomy | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Seven-Year Comparative Outcomes of One Anastomosis Gastric Bypass and Roux-en-Y Gastric Bypass for Weight Recurrence Regain Post Sleeve Gastrectomy Abdelwahed Yahmadi, Asaad Salama, Hamza Al Baba, Jawher Baazaoui, and 2 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8007061/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 11 You are reading this latest preprint version Abstract Background Sleeve gastrectomy (SG) is currently the most commonly performed bariatric procedure worldwide; however, up to half of patients may require conversion surgery due to insufficient weight loss, weight recurrence, or complications. Roux-en-Y gastric bypass (RYGB) and one-anastomosis gastric bypass (OAGB-MGB) are the two most common conversion options, yet evidence regarding long-term comparative outcomes remains limited. Objective This study compared the long-term outcomes of RYGB and OAGB-MGB after SG, focusing on weight loss, comorbidity resolution, complication rates, and nutritional deficiencies. Methods We conducted a retrospective analytic study of all patients who underwent revisional RYGB or OAGB-MGB at our institution between January 2014 and December 2016. Data were extracted from electronic medical records, including demographics, comorbidities, perioperative details, and anthropometric and biochemical measures at baseline, 1, 5, and 7 years. Statistical analysis was performed using SPSS version 26. Results 109 patients were included (47 OAGB-MGB, 62 RYGB). Operative time was significantly shorter for OAGB-MGB. Both procedures achieved durable weight loss; however, OAGB-MGB yielded superior long-term outcomes, with greater %TWL and BMI reduction at one and seven years ( p < 0.05). RYGB was significantly more effective for GERD resolution ( p = 0.002). Rates of diabetes, hypertension, and dyslipidaemia remission were comparable. Complication rates were low and similar, though nutritional deficiencies, particularly iron deficiency, were more common in OAGB-MGB. Conclusion OAGB-MGB provided superior long-term weight loss, while RYGB offered better GERD resolution. Both procedures were safe and effective, underscoring the need for individualised procedure selection. Bariatric surgery sleeve gastrectomy Roux-en-Y gastric bypass one-anastomosis gastric bypass revisional surgery Figures Figure 1 Introduction Obesity has turned into one of the most acute public health issues globally, and its prevalence rates have been rising continuously during the last few decades ( 1 , 2 ). There is a broad range of severe comorbidities associated with the condition, such as type 2 diabetes mellitus, hypertension, dyslipidaemia, cardiovascular disease, obstructive sleep apnoea, and gastroesophageal reflux disease ( 3 , 4 ). Furthermore, obesity has a profound negative impact on life quality and lifespan, in addition to being a significant financial burden on the healthcare systems ( 5 ). Lifestyle change and pharmacological and behavioural interventions usually have limited and short-term outcomes, demonstrating the importance of bariatric surgery as the most effective intervention in securing sustainable weight loss and a better life outcome concerning obesity ( 6 ). Of the several types of bariatric surgery, laparoscopic sleeve gastrectomy (LSG) has recently become the most commonly performed procedure ( 7 , 8 ). Its popularity could be attributed to its relative technical ease, less operative time, and positive short-term weight reduction and comorbidity remission rates, like bypass procedures ( 9 ). In the 2023 International Federation of Surgery of Obesity and Metabolic Disorders (IFSO) global registry report, LSG reported 60.4% of all bariatric surgeries worldwide ( 10 ). However, despite these positive results, long-term follow-up studies have demonstrated that LSG has significant limitations ( 11 – 13 ). Some of these studies have observed that 30–50% of patients can eventually undergo revisional surgery because of insufficient weight loss, weight regain, or complications related to the sleeve itself, like severe gastroesophageal reflux disease, gastric stenosis, or dilation ( 14 – 18 ) Thus, conversion surgery following LSG is gaining widespread popularity, with the Roux-en-Y gastric bypass (RYGB) and the one-anastomosis gastric bypass (OAGB) being the most commonly performed surgeries in this scenario ( 7 – 9 , 19 ). RYGB is considered the gold standard for bariatric and revision surgery, with long-lasting weight loss and resolution of comorbidities ( 20 ). Its technical nature, though, and threats of internal hernia, marginal ulcers, and micronutrient deficiencies are also considered. OAGB, also known as mini-gastric bypass, is a more recent variation of gastric bypass surgery, by contrast. Its design is a single gastrojejunal anastomosis, which is technically easier and faster to do ( 21 ). Moreover, establishing a longer biliopancreatic limb provides a more potent malabsorptive action, which can translate into more permanent weight loss than RYGB. The literature contains many studies comparing RYGB and OAGB after the failure of LSG, but most of them are short-term or mid-term based studies, usually happening within three to five years post-surgery. There have been no long-term data in the past five years, even though it is crucial to analyse the efficiency and safety of revisional procedures. Since obesity is a chronic and relapsing condition, long-term comparative results are the most valuable in conceptualising the long-term durability of weight loss, the remission of comorbidities, and the patterns of complications. Therefore, this study compares the long-term (5- and 7-year) safety of RYGB and OAGB as revisional surgery following LSG regarding weight loss effectiveness and correction of obesity-related comorbidities. Moreover, the secondary goal is to contrast the long-lasting safety charts of the two procedures, mainly focusing on the rates of complications and nutritional deficits. This study hopes to offer clinically relevant evidence to guide surgeons and patients in choosing the best revisional strategy that can be used to maximise long-term outcomes by focusing on both efficacy and safety in the long term. Methodology This research was intended as retrospective analytic research at our institution. All the patients who had previously undergone RYGB or OAGB revisional surgeries, after sleeve gastrectomy (SG), were used as the study population. The research time frame was (January 1, 2014-December 31, 2016) for patients who had undergone the conversion procedure. The time frame was chosen to ensure sufficient time for follow-up, which allowed the assessment of results within a seven-year time frame after the surgery. The patients were recognised using the hospital’s bariatric surgery database, and their clinical information was accessed in electronic medical records. The “failure” of sleeve gastrectomy was determined according to the accepted international standards: a lack of weight loss (loss of excess weight less than 50% after 18–24 months), excessive weight recurrence regain following an initial successful response. Patients who underwent conversion surgery to address sleeve gastrectomy complications were excluded. On the other hand, only those patients who underwent a conversion to address weight loss or metabolic outcome were included. Data collection was done systematically and comprised a broad spectrum of variables. The demographic information included age, sex, and body mass index (BMI) before revisional surgery. Clinical variables comprised obesity-related comorbidities like type 2 diabetes mellitus, hypertension, dyslipidaemia, obstructive sleep apnoea, asthma, and gastroesophageal reflux disease. Recorded operative details consisted of the nature of revisional surgery (RYGB or OAGB), time of operation, intraoperative observations, and immediate intraoperative complications. Each patient was also recorded on the length of his or her stay in the hospital. Anthropometric measurements were taken at specific intervals, such as preoperative, 1, 5, and 7 years postoperative. These were body weight, BMI, percentage of excess weight loss, and percentage of total weight loss. The levels of haemoglobin, ferritin, vitamin B12, folates, calcium, and vitamin D were also tested at the same points of follow-up to determine nutritional deficiencies. The outcome of comorbidity was measured by complete remission, partial improvement, or no change/worsening based on the commonly accepted clinical definitions. The complications were divided into early (within 30 days of surgery) and late (after 30 days), and further subdivided into the means of surgical complications (including leak, bleeding, internal hernia, bowel obstruction, stricture, and marginal ulcer) and nutritional complications (including iron deficiency anaemia, vitamin deficiencies, and severe protein-calorie malnutrition). To reduce information loss, follow-up data were obtained through outpatient clinic visits, laboratory test results, and telephone interviews with patients (where needed). Two investigators reviewed all the data separately to ensure uniformity, and disagreements were settled through consensus. The Statistical Package of the Social Sciences (SPSS), version 26.0 (IBM Corp., Armonk, NY, USA), was used for statistical analysis. The continuous variables were presented in terms of means and standard deviation, whereas the categorical variables were presented in terms of frequencies and percentages. The t-test of students or the Mann-Whitney U-test was applied to the RYGB vs. OAGB groups to compare the continuous variables according to the normality of data. Categorical variables were tested using the chi-square or Fisher’s exact test. The p-value < 0.05 was deemed significant. Kaplan-Meier survival analysis was applied to evaluate the likelihood of being free of revision-related complications over time. Cox proportional hazards regression was used to assess predictors of long-term outcomes. The institutional review board of [Institution name] had granted ethical approval for this retrospective study, and the study's conduct followed the principles of the Declaration of Helsinki. Since this was a retrospective review of existing records, individual informed consent was no longer required. Findings Baseline Characteristics The analysis involved 109 patients who had revisional bariatric surgery following sleeve gastrectomy, 47 of whom had OAGB-MGB and 62 of whom had RYGB. Table 1 summarises the demographic and clinical characteristics of the two groups at baseline. The ages of OAGB-MGB and RYGB were similar (38.1 ± 9.2 vs. 40.7 ± 9.5, p = 0.167 ). The sex distribution was also no different, with females representing predominance in both groups (85.1% in OAGB-MGB vs. 83.9% in RYGB, p = 1.000 ). There was no significant difference between the period of sleeve gastrectomy and revisional surgery (3.8 ± 1.3 vs. 4.1 ± 1.3 years, p = 0.145 ). Similarly, the two groups had comparable height, post-LSG weight, and post-LSG BMI. Regarding post-LSG outcome, the lowest recorded BMI in patients in the OAGB-MGB group was higher than in patients in the RYGB group (36.6 ± 6.7 vs. 33.8 ± 6.1 kg/m 2 , p = 0.028 ). The OAGB-MGB group was found to have significantly higher BMI before revisional surgery (43.3 ± 7.1 vs. 40.2 ± 6.5 kg/m 2 , p = 0.029 ). All other parameters, such as ASA score and the presence of comorbidities, such as diabetes, hypertension, dyslipidaemia, asthma, and obstructive sleep apnoea, were similar across groups. It is also important to note that the rate of gastroesophageal reflux disease (GERD) was much higher in the RYGB group than the OAGB-MGB (50.0% vs. 6.4%, p < 0.001 ). Table 1 Baseline characteristics Variable OAGB-MGB (n = 47) RYGB (n = 62) P-value Age (years) 38.1 ± 9.2 40.7 ± 9.5 0.167 Sex (M/F) M: 7 (14.9%), F: 40 (85.1%) M: 10 (16.1%), F: 52 (83.9%) 1.000 Years from LSG to revision 3.8 ± 1.3 4.1 ± 1.3 0.145 Height (cm) 162.2 ± 10.5 162.9 ± 6.9 0.699 Weight Before LSG (kg) 130.0 ± 27.8 128.7 ± 27.0 0.428 BMI Before LSG (kg/m²) 50.4 ± 8.5 48.2 ± 8.3 0.178 Lowest Weight after LSG (kg) 96.4 ± 20.3 90.1 ± 18.0 0.097 Lowest BMI after LSG (kg/m²) 36.6 ± 6.7 33.8 ± 6.1 0.028 Weight before revisional surgery (kg) 113.8 ± 20.1 107.2 ± 21.2 0.179 BMI before revisional surgery (kg/m²) 43.3 ± 7.1 40.2 ± 6.5 0.029 ASA Score (I–IV) 2.1 ± 0.7 2.1 ± 0.6 0.735 Diabetes 6 (12.8%) 11 (17.7%) 0.658 Hypertension 7 (14.9%) 11 (17.7%) 0.730 Dyslipidaemia 4 (8.5%) 10 (16.1%) 0.206 Obstructive Sleep Apnoea (OSA) 0 (0.0%) 2 (3.2%) 0.087 Asthma 5 (10.6%) 7 (11.3%) 0.837 GERD 3 (6.4%) 31 (50.0%) < 0.001 Intraoperative and Postoperative Data Table 2 presents the perioperative outcomes. The operative time was also much less in the OAGB-MGB group than in RYGB (median 77.5 minutes [IQR: 62.096.8]) vs. 110.0 minutes [IQR: 90.0140.0], p < 0.001 . There were no significant differences in length of stay in hospital between the groups (median 3.0 vs. 4.0 days, p = 0.280 ). The intraoperative bleeding was also uncommon and was found among one patient in each group ( p = 1.000). There was one postoperative leak in the OAGB-MGB group, and no leak was reported in the RYGB group ( p = 0.431 ). Table 2 Intraoperative and Postoperative Data Variable OAGB-MGB (n = 47) RYGB (n = 62) p-value N available Operative time (minutes) 77.5 [62.0-96.8] 110.0 [90.0-140.0] < 0.001 OAGB-MGB: 46, RYGB: 60 Length of Hospital Stay (days) 3.0 [3.0–4.0] 4.0 [3.0–4.0] 0.280 OAGB-MGB: 46, RYGB: 62 Intraoperative Bleeding (yes/ no) 1 (2.1) 1 (1.6) 1.000 OAGB-MGB: 47, RYGB: 62 Postoperative Leak (yes/no) 1 (2.1) 0 (0.0) 0.431 OAGB-MGB: 47, RYGB: 62 Anthropometric Outcomes Table 3 has the anthropometric results at 1-, 5-, and 7-year post-revision operation. Both groups experienced significant weight loss in one year postoperatively. Absolute weight and BMI did not differ significantly between OAGB-MGB and RYGB. Nonetheless, the %TWL was much higher in the OAGB-MGB group (18.76 ± 9.12 vs. 15.04 ± 8.44, p = 0.032 ), and the BMI decrease was also greater (8.24 ± 4.65 vs. 6.07 ± 3.44, p = 0.006 ). At five years, the weight, BMI, and the %EWL and %TWL showed no statistically significant differences, and the BMI was reduced. At seven years, disparities reoccurred once more in support of OAGB-MGB. Although the absolute weight and the BMI were similar, OAGB-MGB patients showed a higher percentage of TWL (18.76 vs. 13.23) and an increased reduction in BMI (8.36 vs. 5.44). These results indicate that OAGB-MGB has better weight loss maintenance over time than RYGB. Table 3 Anthropometric Outcomes Comparison of OAGB-MGB versus RYGB after Sleeve Gastrectomy Variable OAGB-MGB mean ± SD RYGB mean ± SD p-value BMI before revisional surgery (kg/m²) 43.31 ± 7.08 40.22 ± 6.46 0.019 Regained Weight (kg) before revision 17.43 ± 11.49 22.90 ± 22.56 0.131 Weight (kg) at 1 year 92.23 ± 16.48 89.61 ± 17.99 0.443 BMI (kg/m²) at 1 year 35.50 ± 6.44 33.73 ± 5.90 0.218 %EWL at 1 year 47.79 ± 24.34 43.47 ± 27.49 0.466 %TWL at 1 year 18.76 ± 9.12 15.04 ± 8.44 0.032 BMI Reduction at 1 year 8.24 ± 4.65 6.07 ± 3.44 0.006 Weight (kg) at 5 years 96.07 ± 19.10 92.15 ± 19.27 0.300 BMI (kg/m²) at 5 years 36.65 ± 7.29 34.94 ± 6.07 0.129 %EWL at 5 years 36.78 ± 11.39 34.49 ± 14.47 0.785 %TWL at 5 years 15.08 ± 13.31 12.49 ± 10.67 0.270 BMI Reduction at 5 years 6.81 ± 5.07 5.13 ± 4.05 0.1103 Weight (kg) at 7 years 91.38 ± 18.11 92.17 ± 20.48 0.839 BMI (kg/m²) at 7 years 35.53 ± 7.35 34.55 ± 6.05 0.673 %EWL at 7 years 41.75 ± 11.78 37.43 ± 12.85 0.627 %TWL at 7 years 18.76 ± 13.07 13.23 ± 12.28 0.028 BMI Reduction at 7 years 8.36 ± 6.24 5.44 ± 4.96 0.008 Comorbidity Outcomes Table 4 summarizes the comorbidity outcomes after revision surgery. In both groups, diabetes remission was limited. It did not differ significantly, with only one patient in each group showing complete remission (2%), and the proportions of improvement were the same (p = 0.39). Hypertension remission was also rare, with isolated cases of complete remission or improvement in both groups (p = 0.29). The dyslipidemia results were similar, and no significant differences in remission or improvement were observed (p = 0.60). Regarding obstructive sleep apnea, two RYGB group participants achieved full remission, while none in the OAGB-MGB group did (p = 0.21). Improvement rates were high in both groups (100% for OAGB-MGB and 97% for RYGB). The results for asthma were low overall. For GERD, there was a significant difference: RYGB resulted in a much higher remission rate and improvement than OAGB-MGB. Specifically, 21% of patients were in full remission, and 10% showed improvement, unlike in RYGB, only 2% in OAGB-MGB showed improvement (p = 0.002). These findings suggest that RYGB is more effective than OAGB-MGB in managing GERD after sleeve gastrectomy. Table 4 Comorbidity Outcomes Comparison of OAGB-MGB versus RYGB after Sleeve Gastrectomy Variable OAGB-MGB RYGB p-value Diabetes: Complete Remission 1 (2%) 1 (2%) 0.39 Improved 4 (9%) 3 (5%) 0.39 No Changes/Worse 1 (2%) 6 (10%) 0.39 Hypertension: Complete Remission 1 (2%) 0.29 Improved 1 (2%) 0 (0%) 0.29 No Changes/Worse 3 (6%) 8 (13%) 0.29 Dyslipidemia: Complete Remission 2 (4%) 4 (6%) 0.6 Improved 0 (0%) 2 (3%) 0.6 No Changes/Worse 2 (4%) 2 (3%) 0.6 OSA - Complete Remission 0 (0%) 2 (3%) 0.21 Improved 47 (100%) 60 (97%) 0.21 Asthma: Complete Remission 1 (2%) 0 (0%) 0.71 Improved 0 (0%) 1 (2%) 0.71 No Change/Worse 3 (6%) 2 (3%) 0.71 GERD: Complete Remission 1 (2%) 13 (21%) 0.002 Improved 0 (0%) 6 (10%) 0.002 No Changes/Worse 7 (15%) 6 (10%) 0.002 Complications and Nutritional Outcomes Postoperative complications were generally not common and showed no significant differences when compared to each other, as shown in Table 5 . Bleeding, leaks, marginal ulcers, internal hernias, dumping syndrome, and malnutrition rates did not differ significantly statistically. Nutritional complications were predominant. There was a slightly higher rate of vitamin deficiencies in the RYGB group (29% compared to 17% in OAGB-MGB), although this was not statistically significant (p = 0.138). Similarly, iron deficiency anaemia was observed in both groups, with a tendency toward higher prevalence in OAGB-MGB (57.4% vs. 43.5%, p = 0.154). Severe malnutrition was also uncommon and was only reported in one patient in the RYGB group. In summary, both revisional procedures had similar safety profiles, and OAGB-MGB achieved better long-term weight loss, while RYGB provided better GERD relief (Fig. 1 ). Table 5 Comparison of Complications Outcomes Following OAGB-MGB versus RYGB Variable OAGB-MGB Mean ± SD RYGB Mean ± SD p-value Bleeding (Yes = 1, No = 0) 0.021 ± 0.146 0.016 ± 0.127 0.8475 Leak (Yes = 1, No = 0) 0.021 ± 0.146 0.000 ± 0.000 0.3225 Marginal Ulcer (Yes = 1, No = 0) 0.064 ± 0.247 0.065 ± 0.248 0.9886 Internal Hernia (Yes = 1, No = 0) 0.000 ± 0.000 0.032 ± 0.178 0.1590 Bowel Obstruction (Yes = 1, No = 0) 0.000 ± 0.000 0.000 ± 0.000 NA Dumping Syndrome (Yes = 1, No = 0) 0.085 ± 0.282 0.145 ± 0.355 0.3275 Stricture (Yes = 1, No = 0) 0.000 ± 0.000 0.000 ± 0.000 NA Vitamin Deficiencies 0.170 ± 0.380 0.290 ± 0.458 0.1377 Severe Malnutrition (Yes = 1, No = 0) 0.000 ± 0.000 0.016 ± 0.127 0.3213 Iron Deficiency Anemia 0.574 ± 0.500 0.435 ± 0.500 0.1536 Discussion This study compares the OAGB-MGB and the RYGB in patients who have SG. The results contribute to the limited research on long-term outcomes after five years. Significant differences in weight loss sustainability, GERD resolution, and nutritional deficiencies are shown by our findings for the two revisional techniques. Additionally, OAGB-MGB demonstrated better long-term weight loss results, while RYGB was more effective in treating GERD. Long-Term Weight Loss Outcomes Both procedures demonstrated impressive results as revisional options after sleeve gastrectomy. Nonetheless, OAGB-MGB patients experienced a significantly higher percentage of total weight loss (%TWL) and BMI reduction compared to RYGB at one and seven years. These results align with other mid-term studies that have shown greater weight loss after OAGB-MGB compared to RYGB. This difference is explained by the longer biliopancreatic limb and a higher proportion of malabsorptive factors in OAGB-MGB. According to the literature, OAGB-MGB not only has a shorter operative time but also exhibits stronger metabolic effects due to its intestinal bypass design ( 22 , 23 ). Our data further elaborates on these findings by demonstrating the long-term weight loss benefits of OAGB-MGB up to seven years. Resolution of Comorbidities In this cohort, the influence of revisional procedures on obesity-related comorbidities was less pronounced compared to their effect on weight loss outcomes. There were low rates of complete remission or improvement in diabetes, hypertension, dyslipidemia, obstructive sleep apnea, or asthma in both groups, and no significant differences were observed. This is partly due to the relatively low prevalence of these conditions in the study population, which reduces the statistical power to detect meaningful differences. Conversely, there was a clear difference in GERD outcomes between the two procedures. RYGB resulted in significantly higher rates of GERD remission and improvement compared to OAGB-MGB, which aligns with the well-established practice that RYGB is the preferred procedure for patients with severe or refractory GERD ( 23 ). The mechanism involves diverting refluxing bile and reducing exposure to gastric acid through the Roux limb configuration ( 24 ). Conversely, OAGB-MGB has been reported to have a certain likelihood of increasing bile reflux, which explains why GERD was not effectively resolved in this cohort. These findings emphasize the importance of selecting the procedure based on each individual case. For patients with SG and complications from GERD, RYGB is the most effective revisional treatment. However, OAGB-MGB might be the best choice for those without reflux disease who have experienced significant weight regain. Perioperative and Safety Outcomes Regarding perioperative outcomes, it was shown that OAGB-MGB had the shortest operative time compared to RYGB because of its technically simpler single-anastomosis design. This has been repeatedly observed in previous studies and may potentially lower the risk of surgery, especially in patients with multiple comorbidities or at high-volume surgical centers ( 25 – 27 ). Both groups experienced short hospital stays, minimal intraoperative bleeding, and low postoperative leak rates, demonstrating both procedures' safety. There were no significant differences in major surgical complications, indicating that revisional OAGB-MGB and RYGB can be performed with comparable safety profiles during perioperative periods, as long as they are conducted by experienced bariatric teams. Nutritional Deficiencies and Long-Term Complications Nutrition outcomes remain a significant concern after revisionary bariatric surgery, especially when malabsorptive. We found a tendency for increased vitamin deficiencies in RYGB relative to OAGB-MGB, but it was not statistically significant. On the other hand, iron deficiency anaemia was more common in the OAGB-MGB group, which is in line with this procedure's high level of malabsorption tendency ( 28 ). Marginal ulcer, dumping syndrome, and internal hernia occurred at low rates and showed no significant differences among groups. There was also a low incidence of severe malnutrition, observed in only one patient of the RYGB. These findings suggest that both procedures are safe in the long term. However, OAGB-MGB is slightly more likely to lead to nutrient malabsorption, necessitating close long-term nutritional monitoring and supplementation ( 29 ). Clinical Implications These results highlight the complementary strengths of OAGB-MGB and RYGB when used in revisional procedures. OAGB-MGB appears to be more effective for long-term weight loss, as its operative time is shorter, and its long-term effectiveness has been demonstrated to extend beyond seven years. However, RYGB has a clear advantage in resolving GERD and should be prioritized for patients with reflux symptoms or post-SG complications ( 30 ). Clinically, the findings suggest that OAGB-MGB can be a suitable option for patients aiming for sustained weight loss, particularly those with a higher preoperative BMI or those who have experienced significant weight regain following SG ( 31 ). Clinically, the selection of revisional procedure must be customised, considering patient factors such as baseline BMI, the presence of GERD, comorbidity profile, and adherence to nutritional follow-up. Maximising the long-term outcomes through shared decision-making between patients and surgeons is necessary. Strengths and Limitations The article has several strengths, such as a relatively large sample size, an extensive follow-up period, and direct comparisons of two popular revisional procedures in a real clinical setting. Weight loss and comorbidity results are important aspects that add to the overall understanding of long-term effectiveness. However, some limitations should be acknowledged. The retrospective design introduces the potential for selection bias, where pre-existing GERD or BMI may have influenced the choice of procedure. The study might also be limited because it was conducted at a single center, and the relatively low prevalence of comorbidities in the study population could reduce the ability to detect differences in disease resolution. Furthermore, the assessment of nutritional outcomes mainly focused on deficiency levels without comprehensive, longitudinal monitoring of micronutrients, which could have overlooked subtle differences in metabolism. Conclusion This seven-year comparative study has shown that OAGB-MGB could provide better long-term weight loss results compared to RYGB after sleeve gastrectomy, but RYGB might better manage GERD. The two procedures were not dangerous, and there were minimal complications; nutritional deficiencies were easily controlled. Revisional surgery, therefore, must be an individual decision, and weight loss and reflux control need to be balanced for each patient. Further studies should be conducted in the future involving multicenter prospective studies with larger cohorts to validate these results and improve their generalizability. The definitions of comorbidity, remission, and systematic nutritional monitoring should be standardized to enhance comparability across studies. Additionally, cost-effectiveness studies could provide valuable information regarding the long-term healthcare outcomes of OAGB-MGB versus RYGB as revisional procedures. Declarations Author Contribution A.Y.: wrote the manuscriptA.S.: guided manuscript writingH.A.: collected dataJ.B.: Data analysis and interpretationM.B. and M.A.: critically reviewed and revised the manuscript Acknowledgement The authors would like to thank the Medical Research Center (MRC) for supporting and approving this study, and sincerely thank Dr. Kalpana Singh for her valuable contribution to the data analysis process. References Mohajan D, Mohajan HK. Obesity and its related diseases: a new escalating alarming in global health. J Innovations Med Res. 2023;2(3):12–23. 10.56397/JIMR/2023.03.04 . Haththotuwa RN, Wijeyaratne CN, Senarath U. Worldwide epidemic of obesity. In Obesity and obstetrics 2020 (pp. 3–8). Elsevier 10.1016/B978-0-12-817921-5.00001–1 Althoff MD, Ghincea A, Wood LG, Holguin F, Sharma S. Asthma and three colinear comorbidities: obesity, OSA, and GERD. J Allergy Clin Immunology: Pract. 2021;9(11):3877–84. 10.1016/j.jaip.2021.09.003 . Yuen MM. 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Weiner RA, El-Sayes IA, Weiner SR. LSG: complications—diagnosis and management. In Obesity, Bariatric and Metabolic Surgery: A Practical Guide 2016 (pp. 259–276). Cham: Springer International Publishing. 10.1007/978-3-319-04343-2_27 Sarela AI, Dexter SP, O'Kane M, Menon A, McMahon MJ. Long-term follow-up after laparoscopic sleeve gastrectomy: 8–9-year results. Surg Obes Relat Dis. 2012;8(6):679–84. 10.1016/j.soard.2011.06.020 . Melissas J, Braghetto I, Molina JC, Silecchia G, Iossa A, Iannelli A, Foletto M. Gastroesophageal reflux disease and sleeve gastrectomy. Obes Surg. 2015;25(12):2430–5. 10.1007/s11695-015-1906-1 . Johari Y, Lim G, Wickremasinghe A, Yue H, Seah J, Ooi G, Playfair J, Laurie C, Beech P, Yap K, Hebbard G. Pathophysiological mechanisms of gastro-esophageal reflux after sleeve gastrectomy. Ann Surg. 2022;276(5):e407–16. 10.1097/SLA.0000000000004637 . Masood M, Low D, Deal SB, Kozarek RA. Gastroesophageal reflux disease in obesity: bariatric surgery as both the cause and the cure in the morbidly obese population. J Clin Med. 2023;12(17):5543. 10.3390/jcm12175543 . Yeung KT, Penney N, Ashrafian L, Darzi A, Ashrafian H. Does sleeve gastrectomy expose the distal esophagus to severe reflux? a systematic review and meta-analysis. Ann Surg. 2020;271(2):257–65. 10.1097/SLA.0000000000003275 . Andalib A, Alamri H, Almuhanna Y, Bouchard P, Demyttenaere S, Court O. Short-term outcomes of revisional surgery after sleeve gastrectomy: a comparative analysis of re-sleeve, Roux en-Y gastric bypass, duodenal switch (Roux en-Y and single-anastomosis). Surg Endosc. 2021;35(8):4644–52. 10.1007/s00464-020-07891-z . Giannopoulos S, Pokala B, Stefanidis D. Management of gastrointestinal bleeding following bariatric surgery. Mini-invasive Surg. 2022;6:N–A. 10.20517/2574-1225.2021.135 . Han Y, Jia Y, Wang H, Cao L, Zhao Y. Comparative analysis of weight loss and resolution of comorbidities between laparoscopic sleeve gastrectomy and Roux-en-Y gastric bypass: a systematic review and meta-analysis based on 18 studies. Int J Surg. 2020;76:101–10. 10.1016/j.ijsu.2020.02.035 . Khrucharoen U, Juo YY, Chen Y, Dutson EP. Indications, operative techniques, and outcomes for revisional operation following mini-gastric bypass-one anastomosis gastric bypass: a systematic review. Obes Surg. 2020;30(4):1564–73. 10.1007/s11695-019-04276-7 . Salama AF, Baazaoui J, Shahid F, Singh R, Torres AJ, Bashah MM. Comparative analysis of 5-year efficacy and outcomes of single anastomosis procedures as revisional surgery for weight regain following sleeve gastrectomy. Surg Endosc. 2023;37(10):7548–55. PMCID: PMC10520093. Bashah M, Aleter A, Baazaoui J, El-Menyar A, Torres A, Salama A. Single Anastomosis Duodeno-ileostomy (SADI-S) Versus One Anastomosis Gastric Bypass (OAGB-MGB) as Revisional Procedures for Patients with Weight Recidivism After Sleeve Gastrectomy: a Comparative Analysis of Efficacy and Outcomes. Obes Surg. 2020;30(12):4715–23. PMCID: PMC7719107. Shoar S, Nguyen T, Ona MA, Reddy M, Anand S, Alkuwari MJ, Saber AA. Roux-en-Y gastric bypass reversal: a systematic review. Surg Obes Relat Dis. 2016;12(7):1366–72. 10.1016/j.soard.2016.02.023 . Kermansaravi M, Shahmiri SS, DavarpanahJazi AH, Valizadeh R, Berardi G, Vitiello A, Musella M, Carbajo M. One anastomosis/mini-gastric bypass (OAGB/MGB) as revisional surgery following primary restrictive bariatric procedures: a systematic review and meta-analysis. Obes Surg. 2021;31(1):370–83. 10.1007/s11695-020-05079-x . Rheinwalt KP, Plamper A, Rückbeil MV, Kroh A, Neumann UP, Ulmer TF. One anastomosis gastric bypass–mini-gastric bypass (OAGB-MGB) versus Roux-en-Y gastric bypass (RYGB)—a mid-term cohort study with 612 patients. Obes Surg. 2020;30(4):1230–40. 10.1007/s11695-019-04250-3 . Sakran N, Haj B, Pouwels S, Buchwald JN, Foul SA, Parmar C, Awad A, Arraf J, Omari A, Hamoud M. Standardization of the one-anastomosis gastric bypass procedure for morbid obesity: technical aspects and early outcomes. Surg Laparoscopy Endoscopy Percutaneous Techniques. 2023;33(2):162–70. Zarshenas N, Tapsell LC, Batterham M, Neale EP, Talbot ML. Changes in anthropometric measures, nutritional indices and gastrointestinal symptoms following one anastomosis gastric bypass (OAGB) compared with Roux-en-y gastric bypass (RYGB). Obes Surg. 2021;31(6):2619–31. 10.1007/s11695-021-05284-2 . Rossoni C, Bragança R, Santos Z, Viveiros O, Ribeiro R. OAGB bowel function in patients with up to 5 years follow-up: updated outcomes. Obes Surg. 2024;34(1):141–9. 10.1007/s11695-023-06917-4 . Evans LA, Castillo-Larios R, Cornejo J, Elli EF. Challenges of revisional metabolic and bariatric surgery: a comprehensive guide to unraveling the complexities and solutions of revisional bariatric procedures. J Clin Med. 2024;13(11):3104. 10.3390/jcm13113104 . Ansar H, Zamaninour N, Pazouki A, Kabir A. Weight loss after one anastomosis gastric bypass-mini gastric bypass (OAGB-MGB): patient-related perioperative predictive factors. Obes Surg. 2020;30(4):1316–23. 10.1007/s11695-019-04270-z . Additional Declarations No competing interests reported. Cite Share Download PDF Status: Under Review Version 1 posted Editorial decision: Revision requested 05 Jan, 2026 Reviews received at journal 28 Dec, 2025 Reviewers agreed at journal 18 Dec, 2025 Reviews received at journal 18 Dec, 2025 Reviewers agreed at journal 16 Dec, 2025 Reviews received at journal 26 Nov, 2025 Reviewers agreed at journal 14 Nov, 2025 Reviewers invited by journal 12 Nov, 2025 Editor assigned by journal 10 Nov, 2025 Submission checks completed at journal 10 Nov, 2025 First submitted to journal 01 Nov, 2025 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. 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10:28:03\",\"extension\":\"png\",\"order_by\":1,\"title\":\"Figure 1\",\"display\":\"\",\"copyAsset\":false,\"role\":\"figure\",\"size\":287679,\"visible\":true,\"origin\":\"\",\"legend\":\"\\u003cp\\u003e\\u003cstrong\\u003eAnthropometric Outcomes of OAGB-MGB Compared to RYGB After SG\\u003c/strong\\u003e\\u003c/p\\u003e\",\"description\":\"\",\"filename\":\"floatimage1.png\",\"url\":\"https://assets-eu.researchsquare.com/files/rs-8007061/v1/931a7c743cf51254ff5c2b19.png\"},{\"id\":97248468,\"identity\":\"a039cb9d-5fe7-498c-8d0a-cfd55e5742d2\",\"added_by\":\"auto\",\"created_at\":\"2025-12-02 12:59:17\",\"extension\":\"pdf\",\"order_by\":0,\"title\":\"\",\"display\":\"\",\"copyAsset\":false,\"role\":\"manuscript-pdf\",\"size\":1124137,\"visible\":true,\"origin\":\"\",\"legend\":\"\",\"description\":\"\",\"filename\":\"manuscript.pdf\",\"url\":\"https://assets-eu.researchsquare.com/files/rs-8007061/v1/083a4607-a821-4a37-968c-db95811d25ed.pdf\"}],\"financialInterests\":\"No competing interests reported.\",\"formattedTitle\":\"Seven-Year Comparative Outcomes of One Anastomosis Gastric Bypass and Roux-en-Y Gastric Bypass for Weight Recurrence Regain Post Sleeve Gastrectomy\",\"fulltext\":[{\"header\":\"Introduction\",\"content\":\"\\u003cp\\u003eObesity has turned into one of the most acute public health issues globally, and its prevalence rates have been rising continuously during the last few decades (\\u003cspan citationid=\\\"CR1\\\" class=\\\"CitationRef\\\"\\u003e1\\u003c/span\\u003e, \\u003cspan citationid=\\\"CR2\\\" class=\\\"CitationRef\\\"\\u003e2\\u003c/span\\u003e). There is a broad range of severe comorbidities associated with the condition, such as type 2 diabetes mellitus, hypertension, dyslipidaemia, cardiovascular disease, obstructive sleep apnoea, and gastroesophageal reflux disease (\\u003cspan citationid=\\\"CR3\\\" class=\\\"CitationRef\\\"\\u003e3\\u003c/span\\u003e, \\u003cspan citationid=\\\"CR4\\\" class=\\\"CitationRef\\\"\\u003e4\\u003c/span\\u003e). Furthermore, obesity has a profound negative impact on life quality and lifespan, in addition to being a significant financial burden on the healthcare systems (\\u003cspan citationid=\\\"CR5\\\" class=\\\"CitationRef\\\"\\u003e5\\u003c/span\\u003e). Lifestyle change and pharmacological and behavioural interventions usually have limited and short-term outcomes, demonstrating the importance of bariatric surgery as the most effective intervention in securing sustainable weight loss and a better life outcome concerning obesity (\\u003cspan citationid=\\\"CR6\\\" class=\\\"CitationRef\\\"\\u003e6\\u003c/span\\u003e).\\u003c/p\\u003e\\u003cp\\u003eOf the several types of bariatric surgery, laparoscopic sleeve gastrectomy (LSG) has recently become the most commonly performed procedure (\\u003cspan citationid=\\\"CR7\\\" class=\\\"CitationRef\\\"\\u003e7\\u003c/span\\u003e, \\u003cspan citationid=\\\"CR8\\\" class=\\\"CitationRef\\\"\\u003e8\\u003c/span\\u003e). Its popularity could be attributed to its relative technical ease, less operative time, and positive short-term weight reduction and comorbidity remission rates, like bypass procedures (\\u003cspan citationid=\\\"CR9\\\" class=\\\"CitationRef\\\"\\u003e9\\u003c/span\\u003e). In the 2023 International Federation of Surgery of Obesity and Metabolic Disorders (IFSO) global registry report, LSG reported 60.4% of all bariatric surgeries worldwide (\\u003cspan citationid=\\\"CR10\\\" class=\\\"CitationRef\\\"\\u003e10\\u003c/span\\u003e). However, despite these positive results, long-term follow-up studies have demonstrated that LSG has significant limitations (\\u003cspan additionalcitationids=\\\"CR12\\\" citationid=\\\"CR11\\\" class=\\\"CitationRef\\\"\\u003e11\\u003c/span\\u003e\\u0026ndash;\\u003cspan citationid=\\\"CR13\\\" class=\\\"CitationRef\\\"\\u003e13\\u003c/span\\u003e). Some of these studies have observed that 30\\u0026ndash;50% of patients can eventually undergo revisional surgery because of insufficient weight loss, weight regain, or complications related to the sleeve itself, like severe gastroesophageal reflux disease, gastric stenosis, or dilation (\\u003cspan additionalcitationids=\\\"CR15 CR16 CR17\\\" citationid=\\\"CR14\\\" class=\\\"CitationRef\\\"\\u003e14\\u003c/span\\u003e\\u0026ndash;\\u003cspan citationid=\\\"CR18\\\" class=\\\"CitationRef\\\"\\u003e18\\u003c/span\\u003e)\\u003c/p\\u003e\\u003cp\\u003eThus, conversion surgery following LSG is gaining widespread popularity, with the Roux-en-Y gastric bypass (RYGB) and the one-anastomosis gastric bypass (OAGB) being the most commonly performed surgeries in this scenario (\\u003cspan additionalcitationids=\\\"CR8\\\" citationid=\\\"CR7\\\" class=\\\"CitationRef\\\"\\u003e7\\u003c/span\\u003e\\u0026ndash;\\u003cspan citationid=\\\"CR9\\\" class=\\\"CitationRef\\\"\\u003e9\\u003c/span\\u003e, \\u003cspan citationid=\\\"CR19\\\" class=\\\"CitationRef\\\"\\u003e19\\u003c/span\\u003e). RYGB is considered the gold standard for bariatric and revision surgery, with long-lasting weight loss and resolution of comorbidities (\\u003cspan citationid=\\\"CR20\\\" class=\\\"CitationRef\\\"\\u003e20\\u003c/span\\u003e). Its technical nature, though, and threats of internal hernia, marginal ulcers, and micronutrient deficiencies are also considered. OAGB, also known as mini-gastric bypass, is a more recent variation of gastric bypass surgery, by contrast. Its design is a single gastrojejunal anastomosis, which is technically easier and faster to do (\\u003cspan citationid=\\\"CR21\\\" class=\\\"CitationRef\\\"\\u003e21\\u003c/span\\u003e). Moreover, establishing a longer biliopancreatic limb provides a more potent malabsorptive action, which can translate into more permanent weight loss than RYGB.\\u003c/p\\u003e\\u003cp\\u003eThe literature contains many studies comparing RYGB and OAGB after the failure of LSG, but most of them are short-term or mid-term based studies, usually happening within three to five years post-surgery. There have been no long-term data in the past five years, even though it is crucial to analyse the efficiency and safety of revisional procedures. Since obesity is a chronic and relapsing condition, long-term comparative results are the most valuable in conceptualising the long-term durability of weight loss, the remission of comorbidities, and the patterns of complications.\\u003c/p\\u003e\\u003cp\\u003eTherefore, this study compares the long-term (5- and 7-year) safety of RYGB and OAGB as revisional surgery following LSG regarding weight loss effectiveness and correction of obesity-related comorbidities. Moreover, the secondary goal is to contrast the long-lasting safety charts of the two procedures, mainly focusing on the rates of complications and nutritional deficits. This study hopes to offer clinically relevant evidence to guide surgeons and patients in choosing the best revisional strategy that can be used to maximise long-term outcomes by focusing on both efficacy and safety in the long term.\\u003c/p\\u003e\"},{\"header\":\"Methodology\",\"content\":\"\\u003cp\\u003eThis research was intended as retrospective analytic research at our institution. All the patients who had previously undergone RYGB or OAGB revisional surgeries, after sleeve gastrectomy (SG), were used as the study population. The research time frame was (January 1, 2014-December 31, 2016) for patients who had undergone the conversion procedure. The time frame was chosen to ensure sufficient time for follow-up, which allowed the assessment of results within a seven-year time frame after the surgery. The patients were recognised using the hospital’s bariatric surgery database, and their clinical information was accessed in electronic medical records.\\u003c/p\\u003e\\u003cp\\u003eThe “failure” of sleeve gastrectomy was determined according to the accepted international standards: a lack of weight loss (loss of excess weight less than 50% after 18–24 months), excessive weight recurrence regain following an initial successful response. Patients who underwent conversion surgery to address sleeve gastrectomy complications were excluded. On the other hand, only those patients who underwent a conversion to address weight loss or metabolic outcome were included.\\u003c/p\\u003e\\u003cp\\u003eData collection was done systematically and comprised a broad spectrum of variables. The demographic information included age, sex, and body mass index (BMI) before revisional surgery. Clinical variables comprised obesity-related comorbidities like type 2 diabetes mellitus, hypertension, dyslipidaemia, obstructive sleep apnoea, asthma, and gastroesophageal reflux disease. Recorded operative details consisted of the nature of revisional surgery (RYGB or OAGB), time of operation, intraoperative observations, and immediate intraoperative complications. Each patient was also recorded on the length of his or her stay in the hospital.\\u003c/p\\u003e\\u003cp\\u003eAnthropometric measurements were taken at specific intervals, such as preoperative, 1, 5, and 7 years postoperative. These were body weight, BMI, percentage of excess weight loss, and percentage of total weight loss. The levels of haemoglobin, ferritin, vitamin B12, folates, calcium, and vitamin D were also tested at the same points of follow-up to determine nutritional deficiencies. The outcome of comorbidity was measured by complete remission, partial improvement, or no change/worsening based on the commonly accepted clinical definitions. The complications were divided into early (within 30 days of surgery) and late (after 30 days), and further subdivided into the means of surgical complications (including leak, bleeding, internal hernia, bowel obstruction, stricture, and marginal ulcer) and nutritional complications (including iron deficiency anaemia, vitamin deficiencies, and severe protein-calorie malnutrition).\\u003c/p\\u003e\\u003cp\\u003eTo reduce information loss, follow-up data were obtained through outpatient clinic visits, laboratory test results, and telephone interviews with patients (where needed). Two investigators reviewed all the data separately to ensure uniformity, and disagreements were settled through consensus.\\u003c/p\\u003e\\u003cp\\u003eThe Statistical Package of the Social Sciences (SPSS), version 26.0 (IBM Corp., Armonk, NY, USA), was used for statistical analysis. The continuous variables were presented in terms of means and standard deviation, whereas the categorical variables were presented in terms of frequencies and percentages. The t-test of students or the Mann-Whitney U-test was applied to the RYGB vs. OAGB groups to compare the continuous variables according to the normality of data. Categorical variables were tested using the chi-square or Fisher’s exact test. The p-value \\u0026lt; 0.05 was deemed significant. Kaplan-Meier survival analysis was applied to evaluate the likelihood of being free of revision-related complications over time. Cox proportional hazards regression was used to assess predictors of long-term outcomes.\\u003c/p\\u003e\\u003cp\\u003e The institutional review board of [Institution name] had granted ethical approval for this retrospective study, and the study's conduct followed the principles of the Declaration of Helsinki. Since this was a retrospective review of existing records, individual informed consent was no longer required.\\u003c/p\\u003e\\u003cdiv id=\\\"Sec3\\\" class=\\\"Section2\\\"\\u003e\\u003cdiv id=\\\"Sec4\\\" class=\\\"Section3\\\"\\u003e\\u003c/div\\u003e\\u003c/div\\u003e\\n\\n\\n\\n\\n\\n\"},{\"header\":\"Findings\",\"content\":\"\\u003ch2\\u003eBaseline Characteristics\\u003c/h2\\u003e\\u003cp\\u003eThe analysis involved 109 patients who had revisional bariatric surgery following sleeve gastrectomy, 47 of whom had OAGB-MGB and 62 of whom had RYGB. Table\\u0026nbsp;\\u003cspan refid=\\\"Tab1\\\" class=\\\"InternalRef\\\"\\u003e1\\u003c/span\\u003e summarises the demographic and clinical characteristics of the two groups at baseline.\\u003c/p\\u003e\\u003cp\\u003eThe ages of OAGB-MGB and RYGB were similar (38.1 ± 9.2 vs. 40.7 ± 9.5, \\u003cem\\u003ep = 0.167\\u003c/em\\u003e). The sex distribution was also no different, with females representing predominance in both groups (85.1% in OAGB-MGB vs. 83.9% in RYGB, \\u003cem\\u003ep = 1.000\\u003c/em\\u003e). There was no significant difference between the period of sleeve gastrectomy and revisional surgery (3.8 ± 1.3 vs. 4.1 ± 1.3 years, \\u003cem\\u003ep = 0.145\\u003c/em\\u003e). Similarly, the two groups had comparable height, post-LSG weight, and post-LSG BMI.\\u003c/p\\u003e\\u003cp\\u003eRegarding post-LSG outcome, the lowest recorded BMI in patients in the OAGB-MGB group was higher than in patients in the RYGB group (36.6 ± 6.7 vs. 33.8 ± 6.1 kg/m\\u003csup\\u003e2\\u003c/sup\\u003e, \\u003cem\\u003ep = 0.028\\u003c/em\\u003e). The OAGB-MGB group was found to have significantly higher BMI before revisional surgery (43.3 ± 7.1 vs. 40.2 ± 6.5 kg/m\\u003csup\\u003e2\\u003c/sup\\u003e, \\u003cem\\u003ep = 0.029\\u003c/em\\u003e). All other parameters, such as ASA score and the presence of comorbidities, such as diabetes, hypertension, dyslipidaemia, asthma, and obstructive sleep apnoea, were similar across groups. It is also important to note that the rate of gastroesophageal reflux disease (GERD) was much higher in the RYGB group than the OAGB-MGB (50.0% vs. 6.4%, \\u003cem\\u003ep \\u0026lt; 0.001\\u003c/em\\u003e).\\u003c/p\\u003e\\u003cp\\u003e\\u003c/p\\u003e\\u003cdiv class=\\\"gridtable\\\"\\u003e\\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c1\\\" colnum=\\\"1\\\"\\u003e\\u003c/div\\u003e\\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c2\\\" colnum=\\\"2\\\"\\u003e\\u003c/div\\u003e\\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c3\\\" colnum=\\\"3\\\"\\u003e\\u003c/div\\u003e\\u003cdiv align=\\\"char\\\" char=\\\".\\\" class=\\\"colspec\\\" colname=\\\"c4\\\" colnum=\\\"4\\\"\\u003e\\u003c/div\\u003e\\u003ctable float=\\\"Yes\\\" id=\\\"Tab1\\\" border=\\\"1\\\"\\u003e\\u003ccaption language=\\\"En\\\"\\u003e\\u003cdiv class=\\\"CaptionNumber\\\"\\u003eTable 1\\u003c/div\\u003e\\u003cdiv class=\\\"CaptionContent\\\"\\u003e\\u003cp\\u003eBaseline characteristics\\u003c/p\\u003e\\u003c/div\\u003e\\u003c/caption\\u003e\\u003ccolgroup cols=\\\"4\\\"\\u003e\\u003c/colgroup\\u003e\\u003cthead\\u003e\\u003ctr\\u003e\\u003cth align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u003cp\\u003eVariable\\u003c/p\\u003e\\u003c/th\\u003e\\u003cth align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u003cp\\u003eOAGB-MGB (n = 47)\\u003c/p\\u003e\\u003c/th\\u003e\\u003cth align=\\\"left\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003eRYGB (n = 62)\\u003c/p\\u003e\\u003c/th\\u003e\\u003cth align=\\\"left\\\" colname=\\\"c4\\\"\\u003e\\u003cp\\u003eP-value\\u003c/p\\u003e\\u003c/th\\u003e\\u003c/tr\\u003e\\u003c/thead\\u003e\\u003ctbody\\u003e\\u003ctr\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u003cp\\u003eAge (years)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u003cp\\u003e38.1 ± 9.2\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003e40.7 ± 9.5\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e\\u003cp\\u003e0.167\\u003c/p\\u003e\\u003c/td\\u003e\\u003c/tr\\u003e\\u003ctr\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u003cp\\u003eSex (M/F)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u003cp\\u003eM: 7 (14.9%), F: 40 (85.1%)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003eM: 10 (16.1%), F: 52 (83.9%)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e\\u003cp\\u003e1.000\\u003c/p\\u003e\\u003c/td\\u003e\\u003c/tr\\u003e\\u003ctr\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u003cp\\u003eYears from LSG to revision\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u003cp\\u003e3.8 ± 1.3\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003e4.1 ± 1.3\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e\\u003cp\\u003e0.145\\u003c/p\\u003e\\u003c/td\\u003e\\u003c/tr\\u003e\\u003ctr\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u003cp\\u003eHeight (cm)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u003cp\\u003e162.2 ± 10.5\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003e162.9 ± 6.9\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e\\u003cp\\u003e0.699\\u003c/p\\u003e\\u003c/td\\u003e\\u003c/tr\\u003e\\u003ctr\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u003cp\\u003eWeight Before LSG (kg)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u003cp\\u003e130.0 ± 27.8\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003e128.7 ± 27.0\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e\\u003cp\\u003e0.428\\u003c/p\\u003e\\u003c/td\\u003e\\u003c/tr\\u003e\\u003ctr\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u003cp\\u003eBMI Before LSG (kg/m²)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u003cp\\u003e50.4 ± 8.5\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003e48.2 ± 8.3\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e\\u003cp\\u003e0.178\\u003c/p\\u003e\\u003c/td\\u003e\\u003c/tr\\u003e\\u003ctr\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u003cp\\u003eLowest Weight after LSG (kg)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u003cp\\u003e96.4 ± 20.3\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003e90.1 ± 18.0\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e\\u003cp\\u003e0.097\\u003c/p\\u003e\\u003c/td\\u003e\\u003c/tr\\u003e\\u003ctr\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u003cp\\u003eLowest BMI after LSG (kg/m²)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u003cp\\u003e36.6 ± 6.7\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003e33.8 ± 6.1\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e\\u003cp\\u003e0.028\\u003c/p\\u003e\\u003c/td\\u003e\\u003c/tr\\u003e\\u003ctr\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u003cp\\u003eWeight before revisional surgery (kg)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u003cp\\u003e113.8 ± 20.1\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003e107.2 ± 21.2\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e\\u003cp\\u003e0.179\\u003c/p\\u003e\\u003c/td\\u003e\\u003c/tr\\u003e\\u003ctr\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u003cp\\u003eBMI before revisional surgery (kg/m²)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u003cp\\u003e43.3 ± 7.1\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003e40.2 ± 6.5\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e\\u003cp\\u003e0.029\\u003c/p\\u003e\\u003c/td\\u003e\\u003c/tr\\u003e\\u003ctr\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u003cp\\u003eASA Score (I–IV)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u003cp\\u003e2.1 ± 0.7\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003e2.1 ± 0.6\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e\\u003cp\\u003e0.735\\u003c/p\\u003e\\u003c/td\\u003e\\u003c/tr\\u003e\\u003ctr\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u003cp\\u003eDiabetes\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u003cp\\u003e6 (12.8%)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003e11 (17.7%)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e\\u003cp\\u003e0.658\\u003c/p\\u003e\\u003c/td\\u003e\\u003c/tr\\u003e\\u003ctr\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u003cp\\u003eHypertension\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u003cp\\u003e7 (14.9%)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003e11 (17.7%)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e\\u003cp\\u003e0.730\\u003c/p\\u003e\\u003c/td\\u003e\\u003c/tr\\u003e\\u003ctr\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u003cp\\u003eDyslipidaemia\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u003cp\\u003e4 (8.5%)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003e10 (16.1%)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e\\u003cp\\u003e0.206\\u003c/p\\u003e\\u003c/td\\u003e\\u003c/tr\\u003e\\u003ctr\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u003cp\\u003eObstructive Sleep Apnoea (OSA)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u003cp\\u003e0 (0.0%)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003e2 (3.2%)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e\\u003cp\\u003e0.087\\u003c/p\\u003e\\u003c/td\\u003e\\u003c/tr\\u003e\\u003ctr\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u003cp\\u003eAsthma\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u003cp\\u003e5 (10.6%)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003e7 (11.3%)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e\\u003cp\\u003e0.837\\u003c/p\\u003e\\u003c/td\\u003e\\u003c/tr\\u003e\\u003ctr\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u003cp\\u003eGERD\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u003cp\\u003e3 (6.4%)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003e31 (50.0%)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e\\u003cp\\u003e\\u0026lt; 0.001\\u003c/p\\u003e\\u003c/td\\u003e\\u003c/tr\\u003e\\u003c/tbody\\u003e\\u003c/table\\u003e\\u003c/div\\u003e\\u003cp\\u003e\\u003c/p\\u003e\\u003ch3\\u003eIntraoperative and Postoperative Data\\u003c/h3\\u003e\\u003cp\\u003eTable\\u0026nbsp;\\u003cspan refid=\\\"Tab2\\\" class=\\\"InternalRef\\\"\\u003e2\\u003c/span\\u003e presents the perioperative outcomes. The operative time was also much less in the OAGB-MGB group than in RYGB (median 77.5 minutes [IQR: 62.096.8]) vs. 110.0 minutes [IQR: 90.0140.0], \\u003cem\\u003ep \\u0026lt; 0.001\\u003c/em\\u003e. There were no significant differences in length of stay in hospital between the groups (median 3.0 vs. 4.0 days, \\u003cem\\u003ep = 0.280\\u003c/em\\u003e). The intraoperative bleeding was also uncommon and was found among one patient in each group (\\u003cem\\u003ep\\u003c/em\\u003e = 1.000). There was one postoperative leak in the OAGB-MGB group, and no leak was reported in the RYGB group (\\u003cem\\u003ep = 0.431\\u003c/em\\u003e).\\u003c/p\\u003e\\u003cp\\u003e\\u003c/p\\u003e\\u003cdiv class=\\\"gridtable\\\"\\u003e\\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c1\\\" colnum=\\\"1\\\"\\u003e\\u003c/div\\u003e\\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c2\\\" colnum=\\\"2\\\"\\u003e\\u003c/div\\u003e\\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c3\\\" colnum=\\\"3\\\"\\u003e\\u003c/div\\u003e\\u003cdiv align=\\\"char\\\" char=\\\".\\\" class=\\\"colspec\\\" colname=\\\"c4\\\" colnum=\\\"4\\\"\\u003e\\u003c/div\\u003e\\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c5\\\" colnum=\\\"5\\\"\\u003e\\u003c/div\\u003e\\u003ctable float=\\\"Yes\\\" id=\\\"Tab2\\\" border=\\\"1\\\"\\u003e\\u003ccaption language=\\\"En\\\"\\u003e\\u003cdiv class=\\\"CaptionNumber\\\"\\u003eTable 2\\u003c/div\\u003e\\u003cdiv class=\\\"CaptionContent\\\"\\u003e\\u003cp\\u003eIntraoperative and Postoperative Data\\u003c/p\\u003e\\u003c/div\\u003e\\u003c/caption\\u003e\\u003ccolgroup cols=\\\"5\\\"\\u003e\\u003c/colgroup\\u003e\\u003cthead\\u003e\\u003ctr\\u003e\\u003cth align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u003cp\\u003eVariable\\u003c/p\\u003e\\u003c/th\\u003e\\u003cth align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u003cp\\u003eOAGB-MGB (n = 47)\\u003c/p\\u003e\\u003c/th\\u003e\\u003cth align=\\\"left\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003eRYGB (n = 62)\\u003c/p\\u003e\\u003c/th\\u003e\\u003cth align=\\\"left\\\" colname=\\\"c4\\\"\\u003e\\u003cp\\u003ep-value\\u003c/p\\u003e\\u003c/th\\u003e\\u003cth align=\\\"left\\\" colname=\\\"c5\\\"\\u003e\\u003cp\\u003eN available\\u003c/p\\u003e\\u003c/th\\u003e\\u003c/tr\\u003e\\u003c/thead\\u003e\\u003ctbody\\u003e\\u003ctr\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u003cp\\u003eOperative time (minutes)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u003cp\\u003e77.5 [62.0-96.8]\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003e110.0 [90.0-140.0]\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e\\u003cp\\u003e\\u003cb\\u003e\\u0026lt; 0.001\\u003c/b\\u003e\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c5\\\"\\u003e\\u003cp\\u003eOAGB-MGB: 46, RYGB: 60\\u003c/p\\u003e\\u003c/td\\u003e\\u003c/tr\\u003e\\u003ctr\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u003cp\\u003eLength of Hospital Stay (days)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u003cp\\u003e3.0 [3.0–4.0]\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003e4.0 [3.0–4.0]\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e\\u003cp\\u003e0.280\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c5\\\"\\u003e\\u003cp\\u003eOAGB-MGB: 46, RYGB: 62\\u003c/p\\u003e\\u003c/td\\u003e\\u003c/tr\\u003e\\u003ctr\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u003cp\\u003eIntraoperative Bleeding (yes/ no)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u003cp\\u003e1 (2.1)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003e1 (1.6)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e\\u003cp\\u003e1.000\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c5\\\"\\u003e\\u003cp\\u003eOAGB-MGB: 47, RYGB: 62\\u003c/p\\u003e\\u003c/td\\u003e\\u003c/tr\\u003e\\u003ctr\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u003cp\\u003ePostoperative Leak (yes/no)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u003cp\\u003e1 (2.1)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003e0 (0.0)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e\\u003cp\\u003e0.431\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c5\\\"\\u003e\\u003cp\\u003eOAGB-MGB: 47, RYGB: 62\\u003c/p\\u003e\\u003c/td\\u003e\\u003c/tr\\u003e\\u003c/tbody\\u003e\\u003c/table\\u003e\\u003c/div\\u003e\\u003cp\\u003e\\u003c/p\\u003e\\u003ch3\\u003eAnthropometric Outcomes\\u003c/h3\\u003e\\u003cp\\u003eTable\\u0026nbsp;\\u003cspan refid=\\\"Tab3\\\" class=\\\"InternalRef\\\"\\u003e3\\u003c/span\\u003e has the anthropometric results at 1-, 5-, and 7-year post-revision operation. Both groups experienced significant weight loss in one year postoperatively. Absolute weight and BMI did not differ significantly between OAGB-MGB and RYGB. Nonetheless, the %TWL was much higher in the OAGB-MGB group (18.76 ± 9.12 vs. 15.04 ± 8.44, \\u003cem\\u003ep = 0.032\\u003c/em\\u003e), and the BMI decrease was also greater (8.24 ± 4.65 vs. 6.07 ± 3.44, \\u003cem\\u003ep = 0.006\\u003c/em\\u003e).\\u003c/p\\u003e\\u003cp\\u003eAt five years, the weight, BMI, and the %EWL and %TWL showed no statistically significant differences, and the BMI was reduced. At seven years, disparities reoccurred once more in support of OAGB-MGB. Although the absolute weight and the BMI were similar, OAGB-MGB patients showed a higher percentage of TWL (18.76 vs. 13.23) and an increased reduction in BMI (8.36 vs. 5.44). These results indicate that OAGB-MGB has better weight loss maintenance over time than RYGB.\\u003c/p\\u003e\\u003cp\\u003e\\u003c/p\\u003e\\u003cdiv class=\\\"gridtable\\\"\\u003e\\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c1\\\" colnum=\\\"1\\\"\\u003e\\u003c/div\\u003e\\u003cdiv align=\\\"char\\\" char=\\\"±\\\" class=\\\"colspec\\\" colname=\\\"c2\\\" colnum=\\\"2\\\"\\u003e\\u003c/div\\u003e\\u003cdiv align=\\\"char\\\" char=\\\"±\\\" class=\\\"colspec\\\" colname=\\\"c3\\\" colnum=\\\"3\\\"\\u003e\\u003c/div\\u003e\\u003cdiv align=\\\"char\\\" char=\\\".\\\" class=\\\"colspec\\\" colname=\\\"c4\\\" colnum=\\\"4\\\"\\u003e\\u003c/div\\u003e\\u003ctable float=\\\"Yes\\\" id=\\\"Tab3\\\" border=\\\"1\\\"\\u003e\\u003ccaption language=\\\"En\\\"\\u003e\\u003cdiv class=\\\"CaptionNumber\\\"\\u003eTable 3\\u003c/div\\u003e\\u003cdiv class=\\\"CaptionContent\\\"\\u003e\\u003cp\\u003eAnthropometric Outcomes Comparison of OAGB-MGB versus RYGB after Sleeve Gastrectomy\\u003c/p\\u003e\\u003c/div\\u003e\\u003c/caption\\u003e\\u003ccolgroup cols=\\\"4\\\"\\u003e\\u003c/colgroup\\u003e\\u003cthead\\u003e\\u003ctr\\u003e\\u003cth align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u003cp\\u003eVariable\\u003c/p\\u003e\\u003c/th\\u003e\\u003cth align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u003cp\\u003eOAGB-MGB mean ± SD\\u003c/p\\u003e\\u003c/th\\u003e\\u003cth align=\\\"left\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003eRYGB mean ± SD\\u003c/p\\u003e\\u003c/th\\u003e\\u003cth align=\\\"left\\\" colname=\\\"c4\\\"\\u003e\\u003cp\\u003ep-value\\u003c/p\\u003e\\u003c/th\\u003e\\u003c/tr\\u003e\\u003c/thead\\u003e\\u003ctbody\\u003e\\u003ctr\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u003cp\\u003eBMI before revisional surgery (kg/m²)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\"±\\\" colname=\\\"c2\\\"\\u003e\\u003cp\\u003e43.31 ± 7.08\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\"±\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003e40.22 ± 6.46\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e\\u003cp\\u003e\\u003cb\\u003e0.019\\u003c/b\\u003e\\u003c/p\\u003e\\u003c/td\\u003e\\u003c/tr\\u003e\\u003ctr\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u003cp\\u003eRegained Weight (kg) before revision\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\"±\\\" colname=\\\"c2\\\"\\u003e\\u003cp\\u003e17.43 ± 11.49\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\"±\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003e22.90 ± 22.56\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e\\u003cp\\u003e0.131\\u003c/p\\u003e\\u003c/td\\u003e\\u003c/tr\\u003e\\u003ctr\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u003cp\\u003eWeight (kg) at 1 year\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\"±\\\" colname=\\\"c2\\\"\\u003e\\u003cp\\u003e92.23 ± 16.48\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\"±\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003e89.61 ± 17.99\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e\\u003cp\\u003e0.443\\u003c/p\\u003e\\u003c/td\\u003e\\u003c/tr\\u003e\\u003ctr\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u003cp\\u003eBMI (kg/m²) at 1 year\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\"±\\\" colname=\\\"c2\\\"\\u003e\\u003cp\\u003e35.50 ± 6.44\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\"±\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003e33.73 ± 5.90\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e\\u003cp\\u003e0.218\\u003c/p\\u003e\\u003c/td\\u003e\\u003c/tr\\u003e\\u003ctr\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u003cp\\u003e%EWL at 1 year\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\"±\\\" colname=\\\"c2\\\"\\u003e\\u003cp\\u003e47.79 ± 24.34\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\"±\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003e43.47 ± 27.49\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e\\u003cp\\u003e0.466\\u003c/p\\u003e\\u003c/td\\u003e\\u003c/tr\\u003e\\u003ctr\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u003cp\\u003e%TWL at 1 year\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\"±\\\" colname=\\\"c2\\\"\\u003e\\u003cp\\u003e18.76 ± 9.12\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\"±\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003e15.04 ± 8.44\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e\\u003cp\\u003e\\u003cb\\u003e0.032\\u003c/b\\u003e\\u003c/p\\u003e\\u003c/td\\u003e\\u003c/tr\\u003e\\u003ctr\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u003cp\\u003eBMI Reduction at 1 year\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\"±\\\" colname=\\\"c2\\\"\\u003e\\u003cp\\u003e8.24 ± 4.65\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\"±\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003e6.07 ± 3.44\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e\\u003cp\\u003e\\u003cb\\u003e0.006\\u003c/b\\u003e\\u003c/p\\u003e\\u003c/td\\u003e\\u003c/tr\\u003e\\u003ctr\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u003cp\\u003eWeight (kg) at 5 years\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\"±\\\" colname=\\\"c2\\\"\\u003e\\u003cp\\u003e96.07 ± 19.10\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\"±\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003e92.15 ± 19.27\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e\\u003cp\\u003e0.300\\u003c/p\\u003e\\u003c/td\\u003e\\u003c/tr\\u003e\\u003ctr\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u003cp\\u003eBMI (kg/m²) at 5 years\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\"±\\\" colname=\\\"c2\\\"\\u003e\\u003cp\\u003e36.65 ± 7.29\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\"±\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003e34.94 ± 6.07\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e\\u003cp\\u003e0.129\\u003c/p\\u003e\\u003c/td\\u003e\\u003c/tr\\u003e\\u003ctr\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u003cp\\u003e%EWL at 5 years\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\"±\\\" colname=\\\"c2\\\"\\u003e\\u003cp\\u003e36.78 ± 11.39\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\"±\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003e34.49 ± 14.47\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e\\u003cp\\u003e0.785\\u003c/p\\u003e\\u003c/td\\u003e\\u003c/tr\\u003e\\u003ctr\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u003cp\\u003e%TWL at 5 years\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\"±\\\" colname=\\\"c2\\\"\\u003e\\u003cp\\u003e15.08 ± 13.31\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\"±\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003e12.49 ± 10.67\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e\\u003cp\\u003e0.270\\u003c/p\\u003e\\u003c/td\\u003e\\u003c/tr\\u003e\\u003ctr\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u003cp\\u003eBMI Reduction at 5 years\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\"±\\\" colname=\\\"c2\\\"\\u003e\\u003cp\\u003e6.81 ± 5.07\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\"±\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003e5.13 ± 4.05\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e\\u003cp\\u003e0.1103\\u003c/p\\u003e\\u003c/td\\u003e\\u003c/tr\\u003e\\u003ctr\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u003cp\\u003eWeight (kg) at 7 years\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\"±\\\" colname=\\\"c2\\\"\\u003e\\u003cp\\u003e91.38 ± 18.11\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\"±\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003e92.17 ± 20.48\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e\\u003cp\\u003e0.839\\u003c/p\\u003e\\u003c/td\\u003e\\u003c/tr\\u003e\\u003ctr\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u003cp\\u003eBMI (kg/m²) at 7 years\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\"±\\\" colname=\\\"c2\\\"\\u003e\\u003cp\\u003e35.53 ± 7.35\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\"±\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003e34.55 ± 6.05\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e\\u003cp\\u003e0.673\\u003c/p\\u003e\\u003c/td\\u003e\\u003c/tr\\u003e\\u003ctr\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u003cp\\u003e%EWL at 7 years\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\"±\\\" colname=\\\"c2\\\"\\u003e\\u003cp\\u003e41.75 ± 11.78\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\"±\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003e37.43 ± 12.85\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e\\u003cp\\u003e0.627\\u003c/p\\u003e\\u003c/td\\u003e\\u003c/tr\\u003e\\u003ctr\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u003cp\\u003e%TWL at 7 years\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\"±\\\" colname=\\\"c2\\\"\\u003e\\u003cp\\u003e18.76 ± 13.07\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\"±\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003e13.23 ± 12.28\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e\\u003cp\\u003e\\u003cb\\u003e0.028\\u003c/b\\u003e\\u003c/p\\u003e\\u003c/td\\u003e\\u003c/tr\\u003e\\u003ctr\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u003cp\\u003eBMI Reduction at 7 years\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\"±\\\" colname=\\\"c2\\\"\\u003e\\u003cp\\u003e8.36 ± 6.24\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\"±\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003e5.44 ± 4.96\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e\\u003cp\\u003e\\u003cb\\u003e0.008\\u003c/b\\u003e\\u003c/p\\u003e\\u003c/td\\u003e\\u003c/tr\\u003e\\u003c/tbody\\u003e\\u003c/table\\u003e\\u003c/div\\u003e\\u003cp\\u003e\\u003c/p\\u003e\\u003ch3\\u003eComorbidity Outcomes\\u003c/h3\\u003e\\u003cp\\u003eTable\\u0026nbsp;\\u003cspan refid=\\\"Tab4\\\" class=\\\"InternalRef\\\"\\u003e4\\u003c/span\\u003e summarizes the comorbidity outcomes after revision surgery. In both groups, diabetes remission was limited. It did not differ significantly, with only one patient in each group showing complete remission (2%), and the proportions of improvement were the same (p = 0.39). Hypertension remission was also rare, with isolated cases of complete remission or improvement in both groups (p = 0.29). The dyslipidemia results were similar, and no significant differences in remission or improvement were observed (p = 0.60).\\u003c/p\\u003e\\u003cp\\u003eRegarding obstructive sleep apnea, two RYGB group participants achieved full remission, while none in the OAGB-MGB group did (p = 0.21). Improvement rates were high in both groups (100% for OAGB-MGB and 97% for RYGB). The results for asthma were low overall. For GERD, there was a significant difference: RYGB resulted in a much higher remission rate and improvement than OAGB-MGB. Specifically, 21% of patients were in full remission, and 10% showed improvement, unlike in RYGB, only 2% in OAGB-MGB showed improvement (p = 0.002). These findings suggest that RYGB is more effective than OAGB-MGB in managing GERD after sleeve gastrectomy.\\u003c/p\\u003e\\u003cp\\u003e\\u003c/p\\u003e\\u003cdiv class=\\\"gridtable\\\"\\u003e\\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c1\\\" colnum=\\\"1\\\"\\u003e\\u003c/div\\u003e\\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c2\\\" colnum=\\\"2\\\"\\u003e\\u003c/div\\u003e\\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c3\\\" colnum=\\\"3\\\"\\u003e\\u003c/div\\u003e\\u003cdiv align=\\\"char\\\" char=\\\".\\\" class=\\\"colspec\\\" colname=\\\"c4\\\" colnum=\\\"4\\\"\\u003e\\u003c/div\\u003e\\u003ctable float=\\\"Yes\\\" id=\\\"Tab4\\\" border=\\\"1\\\"\\u003e\\u003ccaption language=\\\"En\\\"\\u003e\\u003cdiv class=\\\"CaptionNumber\\\"\\u003eTable 4\\u003c/div\\u003e\\u003cdiv class=\\\"CaptionContent\\\"\\u003e\\u003cp\\u003eComorbidity Outcomes Comparison of OAGB-MGB versus RYGB after Sleeve Gastrectomy\\u003c/p\\u003e\\u003c/div\\u003e\\u003c/caption\\u003e\\u003ccolgroup cols=\\\"4\\\"\\u003e\\u003c/colgroup\\u003e\\u003cthead\\u003e\\u003ctr\\u003e\\u003cth align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u003cp\\u003eVariable\\u003c/p\\u003e\\u003c/th\\u003e\\u003cth align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u003cp\\u003eOAGB-MGB\\u003c/p\\u003e\\u003c/th\\u003e\\u003cth align=\\\"left\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003eRYGB\\u003c/p\\u003e\\u003c/th\\u003e\\u003cth align=\\\"left\\\" colname=\\\"c4\\\"\\u003e\\u003cp\\u003ep-value\\u003c/p\\u003e\\u003c/th\\u003e\\u003c/tr\\u003e\\u003c/thead\\u003e\\u003ctbody\\u003e\\u003ctr\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u003cp\\u003eDiabetes: Complete Remission\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u003cp\\u003e1 (2%)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003e1 (2%)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e\\u003cp\\u003e0.39\\u003c/p\\u003e\\u003c/td\\u003e\\u003c/tr\\u003e\\u003ctr\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u003cp\\u003eImproved\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u003cp\\u003e4 (9%)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003e3 (5%)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e\\u003cp\\u003e0.39\\u003c/p\\u003e\\u003c/td\\u003e\\u003c/tr\\u003e\\u003ctr\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u003cp\\u003eNo Changes/Worse\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u003cp\\u003e1 (2%)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003e6 (10%)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e\\u003cp\\u003e0.39\\u003c/p\\u003e\\u003c/td\\u003e\\u003c/tr\\u003e\\u003ctr\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u003cp\\u003eHypertension: Complete Remission\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003e1 (2%)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e\\u003cp\\u003e0.29\\u003c/p\\u003e\\u003c/td\\u003e\\u003c/tr\\u003e\\u003ctr\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u003cp\\u003eImproved\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u003cp\\u003e1 (2%)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003e0 (0%)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e\\u003cp\\u003e0.29\\u003c/p\\u003e\\u003c/td\\u003e\\u003c/tr\\u003e\\u003ctr\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u003cp\\u003eNo Changes/Worse\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u003cp\\u003e3 (6%)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003e8 (13%)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e\\u003cp\\u003e0.29\\u003c/p\\u003e\\u003c/td\\u003e\\u003c/tr\\u003e\\u003ctr\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u003cp\\u003eDyslipidemia: Complete Remission\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u003cp\\u003e2 (4%)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003e4 (6%)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e\\u003cp\\u003e0.6\\u003c/p\\u003e\\u003c/td\\u003e\\u003c/tr\\u003e\\u003ctr\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u003cp\\u003eImproved\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u003cp\\u003e0 (0%)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003e2 (3%)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e\\u003cp\\u003e0.6\\u003c/p\\u003e\\u003c/td\\u003e\\u003c/tr\\u003e\\u003ctr\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u003cp\\u003eNo Changes/Worse\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u003cp\\u003e2 (4%)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003e2 (3%)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e\\u003cp\\u003e0.6\\u003c/p\\u003e\\u003c/td\\u003e\\u003c/tr\\u003e\\u003ctr\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u003cp\\u003eOSA - Complete Remission\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u003cp\\u003e0 (0%)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003e2 (3%)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e\\u003cp\\u003e0.21\\u003c/p\\u003e\\u003c/td\\u003e\\u003c/tr\\u003e\\u003ctr\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u003cp\\u003eImproved\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u003cp\\u003e47 (100%)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003e60 (97%)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e\\u003cp\\u003e0.21\\u003c/p\\u003e\\u003c/td\\u003e\\u003c/tr\\u003e\\u003ctr\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u003cp\\u003eAsthma: Complete Remission\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u003cp\\u003e1 (2%)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003e0 (0%)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e\\u003cp\\u003e0.71\\u003c/p\\u003e\\u003c/td\\u003e\\u003c/tr\\u003e\\u003ctr\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u003cp\\u003eImproved\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u003cp\\u003e0 (0%)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003e1 (2%)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e\\u003cp\\u003e0.71\\u003c/p\\u003e\\u003c/td\\u003e\\u003c/tr\\u003e\\u003ctr\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u003cp\\u003eNo Change/Worse\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u003cp\\u003e3 (6%)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003e2 (3%)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e\\u003cp\\u003e0.71\\u003c/p\\u003e\\u003c/td\\u003e\\u003c/tr\\u003e\\u003ctr\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u003cp\\u003eGERD: Complete Remission\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u003cp\\u003e1 (2%)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003e13 (21%)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e\\u003cp\\u003e0.002\\u003c/p\\u003e\\u003c/td\\u003e\\u003c/tr\\u003e\\u003ctr\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u003cp\\u003eImproved\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u003cp\\u003e0 (0%)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003e6 (10%)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e\\u003cp\\u003e0.002\\u003c/p\\u003e\\u003c/td\\u003e\\u003c/tr\\u003e\\u003ctr\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u003cp\\u003eNo Changes/Worse\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u003cp\\u003e7 (15%)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003e6 (10%)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e\\u003cp\\u003e0.002\\u003c/p\\u003e\\u003c/td\\u003e\\u003c/tr\\u003e\\u003c/tbody\\u003e\\u003c/table\\u003e\\u003c/div\\u003e\\u003cp\\u003e\\u003c/p\\u003e\\u003ch2\\u003eComplications and Nutritional Outcomes\\u003c/h2\\u003e\\u003cp\\u003ePostoperative complications were generally not common and showed no significant differences when compared to each other, as shown in Table\\u0026nbsp;\\u003cspan refid=\\\"Tab5\\\" class=\\\"InternalRef\\\"\\u003e5\\u003c/span\\u003e. Bleeding, leaks, marginal ulcers, internal hernias, dumping syndrome, and malnutrition rates did not differ significantly statistically.\\u003c/p\\u003e\\u003cp\\u003eNutritional complications were predominant. There was a slightly higher rate of vitamin deficiencies in the RYGB group (29% compared to 17% in OAGB-MGB), although this was not statistically significant (p = 0.138). Similarly, iron deficiency anaemia was observed in both groups, with a tendency toward higher prevalence in OAGB-MGB (57.4% vs. 43.5%, p = 0.154). Severe malnutrition was also uncommon and was only reported in one patient in the RYGB group.\\u003c/p\\u003e\\u003cp\\u003eIn summary, both revisional procedures had similar safety profiles, and OAGB-MGB achieved better long-term weight loss, while RYGB provided better GERD relief (Fig.\\u0026nbsp;\\u003cspan refid=\\\"Fig1\\\" class=\\\"InternalRef\\\"\\u003e1\\u003c/span\\u003e).\\u003c/p\\u003e\\u003cp\\u003e\\u003c/p\\u003e\\u003cdiv class=\\\"gridtable\\\"\\u003e\\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c1\\\" colnum=\\\"1\\\"\\u003e\\u003c/div\\u003e\\u003cdiv align=\\\"char\\\" char=\\\"±\\\" class=\\\"colspec\\\" colname=\\\"c2\\\" colnum=\\\"2\\\"\\u003e\\u003c/div\\u003e\\u003cdiv align=\\\"char\\\" char=\\\"±\\\" class=\\\"colspec\\\" colname=\\\"c3\\\" colnum=\\\"3\\\"\\u003e\\u003c/div\\u003e\\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c4\\\" colnum=\\\"4\\\"\\u003e\\u003c/div\\u003e\\u003ctable float=\\\"Yes\\\" id=\\\"Tab5\\\" border=\\\"1\\\"\\u003e\\u003ccaption language=\\\"En\\\"\\u003e\\u003cdiv class=\\\"CaptionNumber\\\"\\u003eTable 5\\u003c/div\\u003e\\u003cdiv class=\\\"CaptionContent\\\"\\u003e\\u003cp\\u003eComparison of Complications Outcomes Following OAGB-MGB versus RYGB\\u003c/p\\u003e\\u003c/div\\u003e\\u003c/caption\\u003e\\u003ccolgroup cols=\\\"4\\\"\\u003e\\u003c/colgroup\\u003e\\u003cthead\\u003e\\u003ctr\\u003e\\u003cth align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u003cp\\u003eVariable\\u003c/p\\u003e\\u003c/th\\u003e\\u003cth align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u003cp\\u003eOAGB-MGB Mean ± SD\\u003c/p\\u003e\\u003c/th\\u003e\\u003cth align=\\\"left\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003eRYGB Mean ± SD\\u003c/p\\u003e\\u003c/th\\u003e\\u003cth align=\\\"left\\\" colname=\\\"c4\\\"\\u003e\\u003cp\\u003ep-value\\u003c/p\\u003e\\u003c/th\\u003e\\u003c/tr\\u003e\\u003c/thead\\u003e\\u003ctbody\\u003e\\u003ctr\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u003cp\\u003eBleeding (Yes = 1, No = 0)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\"±\\\" colname=\\\"c2\\\"\\u003e\\u003cp\\u003e0.021 ± 0.146\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\"±\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003e0.016 ± 0.127\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e\\u003cp\\u003e0.8475\\u003c/p\\u003e\\u003c/td\\u003e\\u003c/tr\\u003e\\u003ctr\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u003cp\\u003eLeak (Yes = 1, No = 0)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\"±\\\" colname=\\\"c2\\\"\\u003e\\u003cp\\u003e0.021 ± 0.146\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\"±\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003e0.000 ± 0.000\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e\\u003cp\\u003e0.3225\\u003c/p\\u003e\\u003c/td\\u003e\\u003c/tr\\u003e\\u003ctr\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u003cp\\u003eMarginal Ulcer (Yes = 1, No = 0)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\"±\\\" colname=\\\"c2\\\"\\u003e\\u003cp\\u003e0.064 ± 0.247\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\"±\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003e0.065 ± 0.248\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e\\u003cp\\u003e0.9886\\u003c/p\\u003e\\u003c/td\\u003e\\u003c/tr\\u003e\\u003ctr\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u003cp\\u003eInternal Hernia (Yes = 1, No = 0)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\"±\\\" colname=\\\"c2\\\"\\u003e\\u003cp\\u003e0.000 ± 0.000\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\"±\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003e0.032 ± 0.178\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e\\u003cp\\u003e0.1590\\u003c/p\\u003e\\u003c/td\\u003e\\u003c/tr\\u003e\\u003ctr\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u003cp\\u003eBowel Obstruction (Yes = 1, No = 0)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\"±\\\" colname=\\\"c2\\\"\\u003e\\u003cp\\u003e0.000 ± 0.000\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\"±\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003e0.000 ± 0.000\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e\\u003cp\\u003eNA\\u003c/p\\u003e\\u003c/td\\u003e\\u003c/tr\\u003e\\u003ctr\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u003cp\\u003eDumping Syndrome (Yes = 1, No = 0)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\"±\\\" colname=\\\"c2\\\"\\u003e\\u003cp\\u003e0.085 ± 0.282\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\"±\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003e0.145 ± 0.355\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e\\u003cp\\u003e0.3275\\u003c/p\\u003e\\u003c/td\\u003e\\u003c/tr\\u003e\\u003ctr\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u003cp\\u003eStricture (Yes = 1, No = 0)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\"±\\\" colname=\\\"c2\\\"\\u003e\\u003cp\\u003e0.000 ± 0.000\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\"±\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003e0.000 ± 0.000\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e\\u003cp\\u003eNA\\u003c/p\\u003e\\u003c/td\\u003e\\u003c/tr\\u003e\\u003ctr\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u003cp\\u003eVitamin Deficiencies\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\"±\\\" colname=\\\"c2\\\"\\u003e\\u003cp\\u003e0.170 ± 0.380\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\"±\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003e0.290 ± 0.458\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e\\u003cp\\u003e0.1377\\u003c/p\\u003e\\u003c/td\\u003e\\u003c/tr\\u003e\\u003ctr\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u003cp\\u003eSevere Malnutrition (Yes = 1, No = 0)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\"±\\\" colname=\\\"c2\\\"\\u003e\\u003cp\\u003e0.000 ± 0.000\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\"±\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003e0.016 ± 0.127\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e\\u003cp\\u003e0.3213\\u003c/p\\u003e\\u003c/td\\u003e\\u003c/tr\\u003e\\u003ctr\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u003cp\\u003eIron Deficiency Anemia\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\"±\\\" colname=\\\"c2\\\"\\u003e\\u003cp\\u003e0.574 ± 0.500\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\"±\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003e0.435 ± 0.500\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e\\u003cp\\u003e0.1536\\u003c/p\\u003e\\u003c/td\\u003e\\u003c/tr\\u003e\\u003c/tbody\\u003e\\u003c/table\\u003e\\u003c/div\\u003e\\u003cp\\u003e\\u003c/p\\u003e\\u003cp\\u003e\\u003c/p\\u003e\"},{\"header\":\"Discussion\",\"content\":\"\\u003cp\\u003eThis study compares the OAGB-MGB and the RYGB in patients who have SG. The results contribute to the limited research on long-term outcomes after five years. Significant differences in weight loss sustainability, GERD resolution, and nutritional deficiencies are shown by our findings for the two revisional techniques. Additionally, OAGB-MGB demonstrated better long-term weight loss results, while RYGB was more effective in treating GERD.\\u003c/p\\u003e\\n\\u003ch3\\u003eLong-Term Weight Loss Outcomes\\u003c/h3\\u003e\\n\\u003cp\\u003eBoth procedures demonstrated impressive results as revisional options after sleeve gastrectomy. Nonetheless, OAGB-MGB patients experienced a significantly higher percentage of total weight loss (%TWL) and BMI reduction compared to RYGB at one and seven years.\\u003c/p\\u003e\\u003cp\\u003eThese results align with other mid-term studies that have shown greater weight loss after OAGB-MGB compared to RYGB. This difference is explained by the longer biliopancreatic limb and a higher proportion of malabsorptive factors in OAGB-MGB. According to the literature, OAGB-MGB not only has a shorter operative time but also exhibits stronger metabolic effects due to its intestinal bypass design (\\u003cspan citationid=\\\"CR22\\\" class=\\\"CitationRef\\\"\\u003e22\\u003c/span\\u003e, \\u003cspan citationid=\\\"CR23\\\" class=\\\"CitationRef\\\"\\u003e23\\u003c/span\\u003e). Our data further elaborates on these findings by demonstrating the long-term weight loss benefits of OAGB-MGB up to seven years.\\u003c/p\\u003e\\u003cdiv id=\\\"Sec11\\\" class=\\\"Section2\\\"\\u003e\\u003ch2\\u003eResolution of Comorbidities\\u003c/h2\\u003e\\u003cp\\u003eIn this cohort, the influence of revisional procedures on obesity-related comorbidities was less pronounced compared to their effect on weight loss outcomes. There were low rates of complete remission or improvement in diabetes, hypertension, dyslipidemia, obstructive sleep apnea, or asthma in both groups, and no significant differences were observed. This is partly due to the relatively low prevalence of these conditions in the study population, which reduces the statistical power to detect meaningful differences.\\u003c/p\\u003e\\u003cp\\u003eConversely, there was a clear difference in GERD outcomes between the two procedures. RYGB resulted in significantly higher rates of GERD remission and improvement compared to OAGB-MGB, which aligns with the well-established practice that RYGB is the preferred procedure for patients with severe or refractory GERD (\\u003cspan citationid=\\\"CR23\\\" class=\\\"CitationRef\\\"\\u003e23\\u003c/span\\u003e). The mechanism involves diverting refluxing bile and reducing exposure to gastric acid through the Roux limb configuration (\\u003cspan citationid=\\\"CR24\\\" class=\\\"CitationRef\\\"\\u003e24\\u003c/span\\u003e). Conversely, OAGB-MGB has been reported to have a certain likelihood of increasing bile reflux, which explains why GERD was not effectively resolved in this cohort.\\u003c/p\\u003e\\u003cp\\u003eThese findings emphasize the importance of selecting the procedure based on each individual case. For patients with SG and complications from GERD, RYGB is the most effective revisional treatment. However, OAGB-MGB might be the best choice for those without reflux disease who have experienced significant weight regain.\\u003c/p\\u003e\\u003c/div\\u003e\\u003cdiv id=\\\"Sec12\\\" class=\\\"Section2\\\"\\u003e\\u003ch2\\u003ePerioperative and Safety Outcomes\\u003c/h2\\u003e\\u003cp\\u003eRegarding perioperative outcomes, it was shown that OAGB-MGB had the shortest operative time compared to RYGB because of its technically simpler single-anastomosis design. This has been repeatedly observed in previous studies and may potentially lower the risk of surgery, especially in patients with multiple comorbidities or at high-volume surgical centers (\\u003cspan additionalcitationids=\\\"CR26\\\" citationid=\\\"CR25\\\" class=\\\"CitationRef\\\"\\u003e25\\u003c/span\\u003e\\u0026ndash;\\u003cspan citationid=\\\"CR27\\\" class=\\\"CitationRef\\\"\\u003e27\\u003c/span\\u003e).\\u003c/p\\u003e\\u003cp\\u003eBoth groups experienced short hospital stays, minimal intraoperative bleeding, and low postoperative leak rates, demonstrating both procedures' safety. There were no significant differences in major surgical complications, indicating that revisional OAGB-MGB and RYGB can be performed with comparable safety profiles during perioperative periods, as long as they are conducted by experienced bariatric teams.\\u003c/p\\u003e\\u003c/div\\u003e\\u003cdiv id=\\\"Sec13\\\" class=\\\"Section2\\\"\\u003e\\u003ch2\\u003eNutritional Deficiencies and Long-Term Complications\\u003c/h2\\u003e\\u003cp\\u003eNutrition outcomes remain a significant concern after revisionary bariatric surgery, especially when malabsorptive. We found a tendency for increased vitamin deficiencies in RYGB relative to OAGB-MGB, but it was not statistically significant. On the other hand, iron deficiency anaemia was more common in the OAGB-MGB group, which is in line with this procedure's high level of malabsorption tendency (\\u003cspan citationid=\\\"CR28\\\" class=\\\"CitationRef\\\"\\u003e28\\u003c/span\\u003e).\\u003c/p\\u003e\\u003cp\\u003eMarginal ulcer, dumping syndrome, and internal hernia occurred at low rates and showed no significant differences among groups. There was also a low incidence of severe malnutrition, observed in only one patient of the RYGB. These findings suggest that both procedures are safe in the long term. However, OAGB-MGB is slightly more likely to lead to nutrient malabsorption, necessitating close long-term nutritional monitoring and supplementation (\\u003cspan citationid=\\\"CR29\\\" class=\\\"CitationRef\\\"\\u003e29\\u003c/span\\u003e).\\u003c/p\\u003e\\u003c/div\\u003e\\u003cdiv id=\\\"Sec14\\\" class=\\\"Section2\\\"\\u003e\\u003ch2\\u003eClinical Implications\\u003c/h2\\u003e\\u003cp\\u003eThese results highlight the complementary strengths of OAGB-MGB and RYGB when used in revisional procedures. OAGB-MGB appears to be more effective for long-term weight loss, as its operative time is shorter, and its long-term effectiveness has been demonstrated to extend beyond seven years. However, RYGB has a clear advantage in resolving GERD and should be prioritized for patients with reflux symptoms or post-SG complications (\\u003cspan citationid=\\\"CR30\\\" class=\\\"CitationRef\\\"\\u003e30\\u003c/span\\u003e). Clinically, the findings suggest that OAGB-MGB can be a suitable option for patients aiming for sustained weight loss, particularly those with a higher preoperative BMI or those who have experienced significant weight regain following SG (\\u003cspan citationid=\\\"CR31\\\" class=\\\"CitationRef\\\"\\u003e31\\u003c/span\\u003e).\\u003c/p\\u003e\\u003cp\\u003eClinically, the selection of revisional procedure must be customised, considering patient factors such as baseline BMI, the presence of GERD, comorbidity profile, and adherence to nutritional follow-up. Maximising the long-term outcomes through shared decision-making between patients and surgeons is necessary.\\u003c/p\\u003e\\u003c/div\\u003e\\u003cdiv id=\\\"Sec15\\\" class=\\\"Section2\\\"\\u003e\\u003ch2\\u003eStrengths and Limitations\\u003c/h2\\u003e\\u003cp\\u003eThe article has several strengths, such as a relatively large sample size, an extensive follow-up period, and direct comparisons of two popular revisional procedures in a real clinical setting. Weight loss and comorbidity results are important aspects that add to the overall understanding of long-term effectiveness. However, some limitations should be acknowledged. The retrospective design introduces the potential for selection bias, where pre-existing GERD or BMI may have influenced the choice of procedure. The study might also be limited because it was conducted at a single center, and the relatively low prevalence of comorbidities in the study population could reduce the ability to detect differences in disease resolution. Furthermore, the assessment of nutritional outcomes mainly focused on deficiency levels without comprehensive, longitudinal monitoring of micronutrients, which could have overlooked subtle differences in metabolism.\\u003c/p\\u003e\\u003c/div\\u003e\"},{\"header\":\"Conclusion\",\"content\":\"\\u003cp\\u003eThis seven-year comparative study has shown that OAGB-MGB could provide better long-term weight loss results compared to RYGB after sleeve gastrectomy, but RYGB might better manage GERD. The two procedures were not dangerous, and there were minimal complications; nutritional deficiencies were easily controlled. Revisional surgery, therefore, must be an individual decision, and weight loss and reflux control need to be balanced for each patient.\\u003c/p\\u003e\\u003cp\\u003eFurther studies should be conducted in the future involving multicenter prospective studies with larger cohorts to validate these results and improve their generalizability. The definitions of comorbidity, remission, and systematic nutritional monitoring should be standardized to enhance comparability across studies. Additionally, cost-effectiveness studies could provide valuable information regarding the long-term healthcare outcomes of OAGB-MGB versus RYGB as revisional procedures.\\u003c/p\\u003e\"},{\"header\":\"Declarations\",\"content\":\"\\u003ch2\\u003eAuthor Contribution\\u003c/h2\\u003e\\u003cp\\u003eA.Y.: wrote the manuscriptA.S.: guided manuscript writingH.A.: collected dataJ.B.: Data analysis and interpretationM.B. and M.A.: critically reviewed and revised the manuscript\\u003c/p\\u003e\\u003ch2\\u003eAcknowledgement\\u003c/h2\\u003e\\u003cp\\u003eThe authors would like to thank the Medical Research Center (MRC) for supporting and approving this study, and sincerely thank Dr. Kalpana Singh for her valuable contribution to the data analysis process.\\u003c/p\\u003e\"},{\"header\":\"References\",\"content\":\"\\u003col\\u003e\\u003cli\\u003e\\u003cspan\\u003eMohajan D, Mohajan HK. Obesity and its related diseases: a new escalating alarming in global health. J Innovations Med Res. 2023;2(3):12\\u0026ndash;23. \\u003cspan class=\\\"ExternalRef\\\"\\u003e\\u003cspan class=\\\"RefSource\\\"\\u003e10.56397/JIMR/2023.03.04\\u003c/span\\u003e\\u003cspan address=\\\"10.56397/JIMR/2023.03.04\\\" targettype=\\\"DOI\\\" class=\\\"RefTarget\\\"\\u003e\\u003c/span\\u003e\\u003c/span\\u003e.\\u003c/span\\u003e\\u003c/li\\u003e\\u003cli\\u003e\\u003cspan\\u003eHaththotuwa RN, Wijeyaratne CN, Senarath U. Worldwide epidemic of obesity. In Obesity and obstetrics 2020 (pp. 3\\u0026ndash;8). Elsevier \\u003cspan class=\\\"ExternalRef\\\"\\u003e\\u003cspan class=\\\"RefSource\\\"\\u003e10.1016/B978-0-12-817921-5.00001\\u0026ndash;1\\u003c/span\\u003e\\u003cspan address=\\\"10.1016/B978-0-12-817921-5.00001\\u0026ndash;1\\\" targettype=\\\"DOI\\\" class=\\\"RefTarget\\\"\\u003e\\u003c/span\\u003e\\u003c/span\\u003e\\u003c/span\\u003e\\u003c/li\\u003e\\u003cli\\u003e\\u003cspan\\u003eAlthoff MD, Ghincea A, Wood LG, Holguin F, Sharma S. 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Obes Surg. 2020;30(4):1564\\u0026ndash;73. \\u003cspan class=\\\"ExternalRef\\\"\\u003e\\u003cspan class=\\\"RefSource\\\"\\u003e10.1007/s11695-019-04276-7\\u003c/span\\u003e\\u003cspan address=\\\"10.1007/s11695-019-04276-7\\\" targettype=\\\"DOI\\\" class=\\\"RefTarget\\\"\\u003e\\u003c/span\\u003e\\u003c/span\\u003e.\\u003c/span\\u003e\\u003c/li\\u003e\\u003cli\\u003e\\u003cspan\\u003eSalama AF, Baazaoui J, Shahid F, Singh R, Torres AJ, Bashah MM. Comparative analysis of 5-year efficacy and outcomes of single anastomosis procedures as revisional surgery for weight regain following sleeve gastrectomy. Surg Endosc. 2023;37(10):7548\\u0026ndash;55. PMCID: PMC10520093.\\u003c/span\\u003e\\u003c/li\\u003e\\u003cli\\u003e\\u003cspan\\u003eBashah M, Aleter A, Baazaoui J, El-Menyar A, Torres A, Salama A. Single Anastomosis Duodeno-ileostomy (SADI-S) Versus One Anastomosis Gastric Bypass (OAGB-MGB) as Revisional Procedures for Patients with Weight Recidivism After Sleeve Gastrectomy: a Comparative Analysis of Efficacy and Outcomes. Obes Surg. 2020;30(12):4715\\u0026ndash;23. PMCID: PMC7719107.\\u003c/span\\u003e\\u003c/li\\u003e\\u003cli\\u003e\\u003cspan\\u003eShoar S, Nguyen T, Ona MA, Reddy M, Anand S, Alkuwari MJ, Saber AA. Roux-en-Y gastric bypass reversal: a systematic review. Surg Obes Relat Dis. 2016;12(7):1366\\u0026ndash;72. \\u003cspan class=\\\"ExternalRef\\\"\\u003e\\u003cspan class=\\\"RefSource\\\"\\u003e10.1016/j.soard.2016.02.023\\u003c/span\\u003e\\u003cspan address=\\\"10.1016/j.soard.2016.02.023\\\" targettype=\\\"DOI\\\" class=\\\"RefTarget\\\"\\u003e\\u003c/span\\u003e\\u003c/span\\u003e.\\u003c/span\\u003e\\u003c/li\\u003e\\u003cli\\u003e\\u003cspan\\u003eKermansaravi M, Shahmiri SS, DavarpanahJazi AH, Valizadeh R, Berardi G, Vitiello A, Musella M, Carbajo M. One anastomosis/mini-gastric bypass (OAGB/MGB) as revisional surgery following primary restrictive bariatric procedures: a systematic review and meta-analysis. Obes Surg. 2021;31(1):370\\u0026ndash;83. \\u003cspan class=\\\"ExternalRef\\\"\\u003e\\u003cspan class=\\\"RefSource\\\"\\u003e10.1007/s11695-020-05079-x\\u003c/span\\u003e\\u003cspan address=\\\"10.1007/s11695-020-05079-x\\\" targettype=\\\"DOI\\\" class=\\\"RefTarget\\\"\\u003e\\u003c/span\\u003e\\u003c/span\\u003e.\\u003c/span\\u003e\\u003c/li\\u003e\\u003cli\\u003e\\u003cspan\\u003eRheinwalt KP, Plamper A, R\\u0026uuml;ckbeil MV, Kroh A, Neumann UP, Ulmer TF. One anastomosis gastric bypass\\u0026ndash;mini-gastric bypass (OAGB-MGB) versus Roux-en-Y gastric bypass (RYGB)\\u0026mdash;a mid-term cohort study with 612 patients. Obes Surg. 2020;30(4):1230\\u0026ndash;40. \\u003cspan class=\\\"ExternalRef\\\"\\u003e\\u003cspan class=\\\"RefSource\\\"\\u003e10.1007/s11695-019-04250-3\\u003c/span\\u003e\\u003cspan address=\\\"10.1007/s11695-019-04250-3\\\" targettype=\\\"DOI\\\" class=\\\"RefTarget\\\"\\u003e\\u003c/span\\u003e\\u003c/span\\u003e.\\u003c/span\\u003e\\u003c/li\\u003e\\u003cli\\u003e\\u003cspan\\u003eSakran N, Haj B, Pouwels S, Buchwald JN, Foul SA, Parmar C, Awad A, Arraf J, Omari A, Hamoud M. Standardization of the one-anastomosis gastric bypass procedure for morbid obesity: technical aspects and early outcomes. Surg Laparoscopy Endoscopy Percutaneous Techniques. 2023;33(2):162\\u0026ndash;70.\\u003c/span\\u003e\\u003c/li\\u003e\\u003cli\\u003e\\u003cspan\\u003eZarshenas N, Tapsell LC, Batterham M, Neale EP, Talbot ML. Changes in anthropometric measures, nutritional indices and gastrointestinal symptoms following one anastomosis gastric bypass (OAGB) compared with Roux-en-y gastric bypass (RYGB). Obes Surg. 2021;31(6):2619\\u0026ndash;31. \\u003cspan class=\\\"ExternalRef\\\"\\u003e\\u003cspan class=\\\"RefSource\\\"\\u003e10.1007/s11695-021-05284-2\\u003c/span\\u003e\\u003cspan address=\\\"10.1007/s11695-021-05284-2\\\" targettype=\\\"DOI\\\" class=\\\"RefTarget\\\"\\u003e\\u003c/span\\u003e\\u003c/span\\u003e.\\u003c/span\\u003e\\u003c/li\\u003e\\u003cli\\u003e\\u003cspan\\u003eRossoni C, Bragan\\u0026ccedil;a R, Santos Z, Viveiros O, Ribeiro R. OAGB bowel function in patients with up to 5 years follow-up: updated outcomes. Obes Surg. 2024;34(1):141\\u0026ndash;9. \\u003cspan class=\\\"ExternalRef\\\"\\u003e\\u003cspan class=\\\"RefSource\\\"\\u003e10.1007/s11695-023-06917-4\\u003c/span\\u003e\\u003cspan address=\\\"10.1007/s11695-023-06917-4\\\" targettype=\\\"DOI\\\" class=\\\"RefTarget\\\"\\u003e\\u003c/span\\u003e\\u003c/span\\u003e.\\u003c/span\\u003e\\u003c/li\\u003e\\u003cli\\u003e\\u003cspan\\u003eEvans LA, Castillo-Larios R, Cornejo J, Elli EF. Challenges of revisional metabolic and bariatric surgery: a comprehensive guide to unraveling the complexities and solutions of revisional bariatric procedures. J Clin Med. 2024;13(11):3104. \\u003cspan class=\\\"ExternalRef\\\"\\u003e\\u003cspan class=\\\"RefSource\\\"\\u003e10.3390/jcm13113104\\u003c/span\\u003e\\u003cspan address=\\\"10.3390/jcm13113104\\\" targettype=\\\"DOI\\\" class=\\\"RefTarget\\\"\\u003e\\u003c/span\\u003e\\u003c/span\\u003e.\\u003c/span\\u003e\\u003c/li\\u003e\\u003cli\\u003e\\u003cspan\\u003eAnsar H, Zamaninour N, Pazouki A, Kabir A. Weight loss after one anastomosis gastric bypass-mini gastric bypass (OAGB-MGB): patient-related perioperative predictive factors. Obes Surg. 2020;30(4):1316\\u0026ndash;23. \\u003cspan class=\\\"ExternalRef\\\"\\u003e\\u003cspan class=\\\"RefSource\\\"\\u003e10.1007/s11695-019-04270-z\\u003c/span\\u003e\\u003cspan address=\\\"10.1007/s11695-019-04270-z\\\" targettype=\\\"DOI\\\" class=\\\"RefTarget\\\"\\u003e\\u003c/span\\u003e\\u003c/span\\u003e.\\u003c/span\\u003e\\u003c/li\\u003e\\u003c/ol\\u003e\"}],\"fulltextSource\":\"\",\"fullText\":\"\",\"funders\":[],\"hasAdminPriorityOnWorkflow\":false,\"hasManuscriptDocX\":true,\"hasOptedInToPreprint\":true,\"hasPassedJournalQc\":\"\",\"hasAnyPriority\":false,\"hideJournal\":false,\"highlight\":\"\",\"institution\":\"\",\"isAcceptedByJournal\":false,\"isAuthorSuppliedPdf\":false,\"isDeskRejected\":\"\",\"isHiddenFromSearch\":false,\"isInQc\":false,\"isInWorkflow\":false,\"isPdf\":false,\"isPdfUpToDate\":true,\"isWithdrawnOrRetracted\":false,\"journal\":{\"display\":true,\"email\":\"info@researchsquare.com\",\"identity\":\"obesity-surgery\",\"isNatureJournal\":false,\"hasQc\":true,\"allowDirectSubmit\":false,\"externalIdentity\":\"obsu\",\"sideBox\":\"Learn more about [Obesity Surgery](https://link.springer.com/journal/11695)\",\"snPcode\":\"11695\",\"submissionUrl\":\"https://submission.springernature.com/new-submission/11695/3\",\"title\":\"Obesity Surgery\",\"twitterHandle\":\"\",\"acdcEnabled\":true,\"dfaEnabled\":true,\"editorialSystem\":\"stoa\",\"reportingPortfolio\":\"Springer Hybrid\",\"inReviewEnabled\":true,\"inReviewRevisionsEnabled\":false},\"keywords\":\"Bariatric surgery, sleeve gastrectomy, Roux-en-Y gastric bypass, one-anastomosis gastric bypass, revisional surgery\",\"lastPublishedDoi\":\"10.21203/rs.3.rs-8007061/v1\",\"lastPublishedDoiUrl\":\"https://doi.org/10.21203/rs.3.rs-8007061/v1\",\"license\":{\"name\":\"CC BY 4.0\",\"url\":\"https://creativecommons.org/licenses/by/4.0/\"},\"manuscriptAbstract\":\"\\u003ch2\\u003eBackground\\u003c/h2\\u003e\\u003cp\\u003eSleeve gastrectomy (SG) is currently the most commonly performed bariatric procedure worldwide; however, up to half of patients may require conversion surgery due to insufficient weight loss, weight recurrence, or complications. Roux-en-Y gastric bypass (RYGB) and one-anastomosis gastric bypass (OAGB-MGB) are the two most common conversion options, yet evidence regarding long-term comparative outcomes remains limited.\\u003c/p\\u003e\\u003ch2\\u003eObjective\\u003c/h2\\u003e\\u003cp\\u003eThis study compared the long-term outcomes of RYGB and OAGB-MGB after SG, focusing on weight loss, comorbidity resolution, complication rates, and nutritional deficiencies.\\u003c/p\\u003e\\u003ch2\\u003eMethods\\u003c/h2\\u003e\\u003cp\\u003eWe conducted a retrospective analytic study of all patients who underwent revisional RYGB or OAGB-MGB at our institution between January 2014 and December 2016. Data were extracted from electronic medical records, including demographics, comorbidities, perioperative details, and anthropometric and biochemical measures at baseline, 1, 5, and 7 years. Statistical analysis was performed using SPSS version 26.\\u003c/p\\u003e\\u003ch2\\u003eResults\\u003c/h2\\u003e\\u003cp\\u003e109 patients were included (47 OAGB-MGB, 62 RYGB). Operative time was significantly shorter for OAGB-MGB. Both procedures achieved durable weight loss; however, OAGB-MGB yielded superior long-term outcomes, with greater %TWL and BMI reduction at one and seven years (\\u003cem\\u003ep\\u003c/em\\u003e\\u0026thinsp;\\u0026lt;\\u0026thinsp;0.05). RYGB was significantly more effective for GERD resolution (\\u003cem\\u003ep\\u003c/em\\u003e\\u0026thinsp;=\\u0026thinsp;0.002). Rates of diabetes, hypertension, and dyslipidaemia remission were comparable. Complication rates were low and similar, though nutritional deficiencies, particularly iron deficiency, were more common in OAGB-MGB.\\u003c/p\\u003e\\u003ch2\\u003eConclusion\\u003c/h2\\u003e\\u003cp\\u003eOAGB-MGB provided superior long-term weight loss, while RYGB offered better GERD resolution. Both procedures were safe and effective, underscoring the need for individualised procedure selection.\\u003c/p\\u003e\",\"manuscriptTitle\":\"Seven-Year Comparative Outcomes of One Anastomosis Gastric Bypass and Roux-en-Y Gastric Bypass for Weight Recurrence Regain Post Sleeve Gastrectomy\",\"msid\":\"\",\"msnumber\":\"\",\"nonDraftVersions\":[{\"code\":1,\"date\":\"2025-11-24 10:27:58\",\"doi\":\"10.21203/rs.3.rs-8007061/v1\",\"editorialEvents\":[{\"type\":\"communityComments\",\"content\":0},{\"type\":\"decision\",\"content\":\"Revision requested\",\"date\":\"2026-01-05T20:19:42+00:00\",\"index\":\"\",\"fulltext\":\"\"},{\"type\":\"editorInvitedReview\",\"content\":\"\",\"date\":\"2025-12-29T04:45:34+00:00\",\"index\":\"hide\",\"fulltext\":\"\"},{\"type\":\"reviewerAgreed\",\"content\":\"133123924041907001504575977801113153468\",\"date\":\"2025-12-18T20:42:13+00:00\",\"index\":\"hide\",\"fulltext\":\"\"},{\"type\":\"editorInvitedReview\",\"content\":\"\",\"date\":\"2025-12-18T18:54:11+00:00\",\"index\":\"hide\",\"fulltext\":\"\"},{\"type\":\"reviewerAgreed\",\"content\":\"118136956838973890528532930523698130167\",\"date\":\"2025-12-16T19:55:35+00:00\",\"index\":\"hide\",\"fulltext\":\"\"},{\"type\":\"editorInvitedReview\",\"content\":\"\",\"date\":\"2025-11-26T18:53:42+00:00\",\"index\":\"hide\",\"fulltext\":\"\"},{\"type\":\"reviewerAgreed\",\"content\":\"325036415784364112381787805268648850133\",\"date\":\"2025-11-14T18:28:03+00:00\",\"index\":\"hide\",\"fulltext\":\"\"},{\"type\":\"reviewersInvited\",\"content\":\"\",\"date\":\"2025-11-13T01:45:20+00:00\",\"index\":\"\",\"fulltext\":\"\"},{\"type\":\"editorAssigned\",\"content\":\"\",\"date\":\"2025-11-10T16:36:50+00:00\",\"index\":\"\",\"fulltext\":\"\"},{\"type\":\"checksComplete\",\"content\":\"\",\"date\":\"2025-11-10T07:09:56+00:00\",\"index\":\"\",\"fulltext\":\"\"},{\"type\":\"submitted\",\"content\":\"Obesity Surgery\",\"date\":\"2025-11-01T16:42:37+00:00\",\"index\":\"\",\"fulltext\":\"\"}],\"status\":\"published\",\"journal\":{\"display\":true,\"email\":\"info@researchsquare.com\",\"identity\":\"obesity-surgery\",\"isNatureJournal\":false,\"hasQc\":true,\"allowDirectSubmit\":false,\"externalIdentity\":\"obsu\",\"sideBox\":\"Learn more about [Obesity Surgery](https://link.springer.com/journal/11695)\",\"snPcode\":\"11695\",\"submissionUrl\":\"https://submission.springernature.com/new-submission/11695/3\",\"title\":\"Obesity Surgery\",\"twitterHandle\":\"\",\"acdcEnabled\":true,\"dfaEnabled\":true,\"editorialSystem\":\"stoa\",\"reportingPortfolio\":\"Springer Hybrid\",\"inReviewEnabled\":true,\"inReviewRevisionsEnabled\":false}}],\"origin\":\"\",\"ownerIdentity\":\"5e03574d-d13f-407d-b0cb-5eb04c8cd796\",\"owner\":[],\"postedDate\":\"November 24th, 2025\",\"published\":true,\"recentEditorialEvents\":[],\"rejectedJournal\":[],\"revision\":\"\",\"amendment\":\"\",\"status\":\"under-review\",\"subjectAreas\":[],\"tags\":[],\"updatedAt\":\"2026-03-31T00:08:10+00:00\",\"versionOfRecord\":[],\"versionCreatedAt\":\"2025-11-24 10:27:58\",\"video\":\"\",\"vorDoi\":\"\",\"vorDoiUrl\":\"\",\"workflowStages\":[]},\"version\":\"v1\",\"identity\":\"rs-8007061\",\"journalConfig\":\"researchsquare\"},\"__N_SSP\":true},\"page\":\"/article/[identity]/[[...version]]\",\"query\":{\"redirect\":\"/article/rs-8007061\",\"identity\":\"rs-8007061\",\"version\":[\"v1\"]},\"buildId\":\"8U1c8b4HqxoKbykW_rLl7\",\"isFallback\":false,\"isExperimentalCompile\":false,\"dynamicIds\":[84888],\"gssp\":true,\"scriptLoader\":[]}","source_license":"CC-BY-4.0","license_restricted":false}